Methotrexate

Methotrexate

1. Systemic medication for the treatment of choriocarcinoma, malignant hydatidiform mole, various acute leukemias with breast cancer, lung cancer, head and neck cancer, digestive tract cancer, cervical cancer and malignant lymphoma. 2. Arterial catheter perfusion has a good effect on head and neck cancer and liver cancer. 3. High-dose methotrexate supplemented with calcium folinate rescue (HDMTX-CFR therapy) has a certain effect as postoperative adjuvant chemotherapy or systemic treatment of advanced lesions for osteosarcoma, soft tissue sarcoma, malignant lymphoma, acute lymphocytic leukemia with breast cancer, ovarian cancer, small cell lung cancer, etc.

1. For the treatment of leukemia, adults usually take 2.5mg to 10mg/day orally, with a total of about 50mg to 150mg. Children take 1.5mg to 5mg/day. 2. For the treatment of choriocarcinoma, etc., take 10mg to 20mg/day, intramuscularly or orally, or intravenously, for 5 to 10 days, and the course of treatment is 80mg to 100mg. 3. For the treatment of head and neck cancer or gynecological cancer, take 10mg to 20mg/time, and administer via arterial catheterization, once a day or every other day, 7 to 10 times for a course of treatment. 4. For the treatment of general solid tumors with normal liver and kidney function, take 30mg to 50mg/time, intravenously, once every 5 to 10 days, 5 to 10 times for a course of treatment; or take 0.4mg/kg each time, intravenously, twice a week. 5. Rescue therapy: First, intravenously inject vincristine 1mg to 2mg/time, and half an hour later, use methotrexate 1g to 5g/m2, and drip for 6 hours. After 4 to 6 hours, start intramuscular injection of calcium folinate, 6mg to 12mg (~15mg) per time, and then inject once every 6 hours for 72 hours. Depending on the situation, the drug can be used once a month.

1 Gastrointestinal reactions mainly include stomatitis, lip ulcers, pharyngitis, nausea, vomiting, gastritis and diarrhea. 2 Bone marrow suppression is mainly manifested by a decrease in leukocytes, which also has a certain effect on platelets. In severe cases, there may be a decrease in whole blood, skin or internal bleeding. 3 A large amount of one-time application may cause an increase in serum alanine aminotransferase (ALT) or drug-induced hepatitis. A small amount of long-term application may cause cirrhosis. 4 Kidney damage is common at high doses, with hematuria, proteinuria, oliguria, azotemia, uremia, etc. 5 There are also hair loss, dermatitis, pigmentation and drug-induced pneumonia. When the dose is too large when injected into the sheath or the head and neck artery, symptoms such as headache, back pain, vomiting, fever and convulsions may occur. 6 Use in early pregnancy may cause teratogenesis. A small number of patients have delayed menstruation and reproductive dysfunction.

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