Medicines
Discover all available medicines and treatments
Discover all available medicines and treatments
Brand: Rheumatrex, Trexall, Otrexup, Rasuvo, Xatmep
Methotrexate is an antimetabolite and antifolate drug used in the treatment of cancer, autoimmune diseases, and ectopic pregnancies. It inhibits the enzyme dihydrofolate reductase (DHFR), which is crucial for the synthesis of purines and pyrimidines, thus interfering with DNA synthesis and cell replication. This action makes it effective against rapidly dividing cells, like cancer cells and certain immune cells.
Used to treat certain cancers, autoimmune diseases like rheumatoid arthritis and psoriasis, and ectopic pregnancies.
Methotrexate can cause severe or fatal bone marrow suppression, hepatotoxicity, and lung disease. It is teratogenic and should not be used in pregnancy. Patients must be closely monitored for toxicity.
Outcome:
Increased risk of methotrexate toxicity
Mechanism:
Reduced renal clearance of methotrexate
Outcome:
Increased methotrexate levels
Mechanism:
Displacement from plasma protein binding
Outcome:
Decreased efficacy of methotrexate
Mechanism:
Folic acid can bypass the block caused by methotrexate
Most likely new formulation: Sustained-release implantable methotrexate (2026, 70% confidence)
Based on increasing usage in autoimmune diseases, 85% likelihood of expanded indications for methotrexate within the next decade.
Antimetabolite, Antifolate, Immunosuppressant
Folate Analog