A dihydrofolate reductase inhibitor.

A classical antifolate agent.

Can cause folate deficiency leading to anemia.

Can cause serious liver and lung toxicity.

MTX-induced pneumonitis is a hypersensitivity pneumonitis that usually develops a few days to several weeks after initiation of methotrexate and is associated with progressive dyspnea, fever, and nonproductive cough.

Methotrexate induced pneumonitis can be associated with eosinophilia in 50% of patients.

Capable of increasing homocysteine levels they could increase the pro thrombotic state.

Some methotrexate-associated toxicities can be avoided with the use of supplemental folate.

Overall incidence of malignancies with the use of this agent is low.

Treatment in patients with rheumatoid arthritis should not include patients with preexisting liver, kidney or lung disease or in patients who wish to continue the use of alcohol.

May be associated with increased risk of lymphoma in patients treated for rheumatoid arthritis.

Low dose treatment may reduce the risk of cardiovascular disease in patients with psoriasis and rheumatoid arthritis.

Wide dosage range from 20mg/m2 in weekly maintenance to doses of 1000-33,000 mg/m2 with leucovorin rescue.

Treatment component for acute lymphoblastic leukemia, lymphoma, osteosarcoma, breast cancer and cancer of the head and neck.

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