Drugs, Supplies and Delivery
Methotrexate is a versatile medication with applications in oncology and autoimmune diseases. As a folate antagonist, it inhibits DNA synthesis and modulates immune responses, making it a cornerstone in treating conditions such as cancer, rheumatoid arthritis (RA), and psoriasis. This article synthesizes information from the British National Formulary (BNF), Lippincott Textbook of Pharmacology, and Lange Basic & Clinical Pharmacology to detail methotrexate’s mechanism, uses, dosing, side effects, precautions, and interactions.
Methotrexate acts as a competitive inhibitor of dihydrofolate reductase (DHFR), an enzyme required to convert folate into tetrahydrofolate, a critical cofactor in DNA and RNA synthesis. By depleting intracellular folate stores, methotrexate:
In oncology, high-dose methotrexate directly targets proliferating malignant cells. In autoimmune conditions, its immunomodulatory effects reduce inflammation and tissue damage (BNF).
Administration:
Methotrexate is the generic name. Brand names include Trexall®, Rheumatrex®, and Otrexup®. Available as tablets (2.5 mg, 5 mg, 10 mg), injectable solutions, and auto-injectors for subcutaneous use.
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