Select a medication above to begin.
Trexall
methotrexate
Black Box Warnings .
Embryo-Fetal Toxicity and Death
may cause embryo-fetal toxicity and death; contraindicated in pregnant patients w/ RA, psoriasis, or JIA, weigh risk/benefit in pregnant patients w/ neoplastic disease; use effective contraception during tx and x6mo after D/C in patients of childbearing potential and during tx and for at least 3mo after D/C in male patients
Hypersensitivity Rxn
contraindicated in patients w/ history of severe hypersens. rxns to methotrexate, incl. anaphylaxis; D/C tx immed. and permanently if serious hypersens. rxn or anaphylaxis
Severe Toxic Rxns
may cause severe or fatal toxicities, incl. bone marrow suppression, serious infections, renal toxicity, GI toxicity, hepatotoxicity, pulmonary toxicity, hypersensitivity and skin rxns; monitor closely, modify dose, or D/C as appropriate
Adult Dosing .
Dosage forms: TAB: 5 mg, 7.5 mg, 10 mg, 15 mg
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments
ALL, maintenance tx
- [individualize dose PO qwk]
- Start: 20 mg/m^2/dose PO qwk; Info: part of multi-drug chemo regimen
mycosis fungoides
- [monotherapy]
- Dose: 25-75 mg PO qwk
- [combo tx]
- Dose: 10 mg/m^2/dose PO 2x/wk
non-Hodgkin lymphoma, relapsed or refractory
- [2.5 mg PO 2-4x/wk]
- Max: 10 mg/wk; Info: part of metronomic multi-drug chemo regimen
rheumatoid arthritis
- [7.5-20 mg PO qwk]
- Start: 7.5 mg PO qwk; Max: 25 mg/wk; Info: use lowest effective dose; give w/ folic acid 1 mg qd or leucovorin 5 mg qwk
psoriasis, severe
- [10-25 mg PO qwk]
- Max: 30 mg/wk; Alt: may give divided doses PO q12h x3 doses qwk; Info: use lowest effective dose; give w/ folic acid 1 mg qd or leucovorin 5 mg qwk
renal dosing
- [see below]
- CrCl 10-50: decr. usual dose by 50%; CrCl <10: avoid use
- HD: decr. usual dose by 50%, on dialysis days admin. after dialysis; no supplement; PD: avoid use
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised; chronic hepatic disease: avoid use
Peds Dosing .
- Dosage forms: TAB: 5 mg, 7.5 mg, 10 mg, 15 mg
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments
ALL, maintenance tx
- [individualize dose PO qwk]
- Start: 20 mg/m^2/dose PO qwk; Info: part of multi-drug chemo regimen
juvenile idiopathic arthritis
- [2 yo and older]
- Dose: 10-20 mg/m^2/dose PO qwk; Start: 10 mg/m^2/dose PO qwk; Max: 25 mg/wk; Info: use lowest effective dose; give w/ folic acid 1 mg qd or leucovorin 5 mg qwk
renal dosing
- [adjust dose amount]
- CrCl 10-50: decr. usual dose by 50%; CrCl <10: decr. usual dose by 70%
- HD: decr. usual dose by 70%, on dialysis days admin. after dialysis; no supplement; PD: decr. usual dose by 70%; no supplement
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised; chronic hepatic disease: avoid use