methotrexate
n a drug that interferes with cell growth and is used to treat various types of cancer, including leukaemia and breast cancer ( see antimetabolite ). It is administered by mouth or injection; common side-effects include mouth sores, digestive upsets, skin rashes, and hair loss.
Methotrexate is used to treat severe psoriasis (a skin disease in which red, scaly patches form on some areas of the body). Methotrexate is also used to treat rheumatoid arthritis (RA; a condition in which the body attacks its own joints, causing pain, swelling, and loss of function). Methotrexate is also used in children to treat polyarticular juvenile idiopathic arthritis (PJIA; a type of childhood arthritis that affects five or more joints during the first six months of the condition, causing pain, swelling, and loss of function). Methotrexate is also used in combination with other chemotherapy medications to treat acute lymphoblastic leukemia (ALL; also called acute lymphoblastic leukemia and acute lymphatic leukemia; a type of cancer that begins in the white blood cells) and non-Hodgkin's lymphoma (NHL; a type of cancer that begins in a type of white blood cells that normally fights infection) that has returned or did not respond to other medications. and Methotrexate is also used alone or combination with other chemotherapy medications to treat mycosis fungoides, a type of cutaneous T-cell lymphoma ([CTCL], a group of cancers of the immune system that first appear as skin rashes). Methotrexate is in a class of medications called antimetabolites. Methotrexate treats cancer by slowing the growth of cancer cells. Methotrexate treats psoriasis by slowing the growth of skin cells to stop scales from forming. Methotrexate may treat rheumatoid arthritis and polyarticular juvenile idiopathic arthritis by decreasing the activity of the immune system.
Full drug information on MedlinePlus →This is general information, not medical advice. Pregnancy and breastfeeding decisions should always be made with your healthcare provider.
Can taking methotrexate affect fertility or make it harder to get pregnant?
According to available data, one study found that women treated with methotrexate for ectopic pregnancy within the prior 6 months had a lower number of eggs, while those treated more than 6 months earlier did not — suggesting any effect may be temporary. Other studies have not shown a higher chance of fertility problems with methotrexate use. Anyone with questions about methotrexate and fertility should discuss them with their healthcare provider.
Does taking methotrexate increase the risk of miscarriage?
Miscarriage can happen in any pregnancy for many reasons. The fact sheet notes that small studies of women using methotrexate to treat rheumatic diseases have reported an increased chance of miscarriage. People taking methotrexate who are pregnant or planning pregnancy should talk with their healthcare provider about what this means for their situation.
Does taking methotrexate increase the risk of birth defects?
The fact sheet explains that taking methotrexate in the first trimester could increase the chance of a specific pattern of birth defects involving the head, face, limbs, and bones, and that heart defects and oral clefts have also been reported, though it is not clear if methotrexate caused them. Limited evidence suggests methotrexate-related birth defects are more likely with exposures of 10 mg or more per week between 6 and 8 weeks after conception, while a review of 101 women with rheumatoid arthritis taking 5–25 mg per week in the first trimester reported no increase in birth defects. Not all babies exposed will have birth defects, and individual situations should be reviewed with a healthcare provider.
Can taking methotrexate during pregnancy cause other pregnancy-related complications?
The fact sheet reports that poor fetal growth (being smaller than expected for the weeks of pregnancy) has been observed in pregnancies affected by methotrexate-related birth defects. Other pregnancy-related complications are not specifically described in the source. A healthcare provider can discuss monitoring and what to expect in an individual pregnancy.
Can taking methotrexate during pregnancy affect the child's brain development, learning, or behavior?
According to the fact sheet, developmental delay, learning problems, and intellectual disability have been reported in some children who have birth defects related to methotrexate exposure during pregnancy. There are no tests available during pregnancy that can predict effects on future behavior or learning. Families with concerns should talk with their healthcare provider about follow-up and developmental monitoring.
Is it safe to breastfeed while taking methotrexate?
The fact sheet states that methotrexate passes into breast milk in small amounts, and the product label recommends not using methotrexate while breastfeeding, although the benefits may sometimes outweigh possible risks. Some providers recommend not breastfeeding during high-dose methotrexate (such as for cancer) and for 1 week after the last dose, while some experts suggest weekly low-dose methotrexate is unlikely to cause problems, with monitoring of the baby's blood count suggested. Decisions about breastfeeding while taking methotrexate should be made together with a healthcare provider.
Source: National Library of Medicine
methotrexate