Methotrexate

Methotrexate (Rheumatrex®) is used dermatologically for the treatment of severe recalcitrant psoriasis; less commonly for the treatment of immune mediated bullous disorders and other conditions.

Contraindications:

• Pregnancy
• Blood dyscrasia, cytopenia
• Liver disease
• Active infectious disease

Precautions:

• Methotrexate therapy carries a very real risk of significant hepatic toxicity. Its use should be judged in relationship to the clinical problem, and to the risks and benefits of alternative therapy.
• Toxicity can be enhanced by the use of concomitant medications such as aspirin, nonsteroidal anti-inflammatory agents, many antibiotics, and dilantin. Please consult your compendium.

Adverse effects:

• GI discomfort, nausea
• Elevation of liver enzymes
• Many others. Please consult your compendium.

Dosage:

• Psoriasis therapy is usually 2.5 mg every 12 hrs x 3, once each week for typical course of 6 weeks.
• A liver biopsy is recommended prior to starting therapy.
• Duration of therapy should be kept to a minimum.

Back to Dermatology Glossary - M Index   |   Back to Dermatology Glossary Index