With rheumatoid arthritis, methotrexate improves the general well-being of the patient and also suppresses inflammatory processes, which helps a person return to his usual lifestyle. Instructions for use of methotrexate are quite complicated – only a specialist can choose a dose and dosage regimen. Methotrexate for rheumatoid arthritis
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The composition and mechanism of action of the drug
The active ingredient of the drug is methotrexate – a folic acid antagonist, cytostatic (which has an antitumor effect) and antimetabolite. The solutions also include water for injection and methylparaben. Formulating substances – starch and cellulose, as well as silicon dioxide, are additionally added to the tablets.
Methotrexate is able to exert several actions on the human body:
- Overwhelming immunity.
Highly dividing cells have a high sensitivity to the active substance of the drug, due to which the production of leukocytes is reduced and immunity is suppressed. Since the disease is based on autoimmune processes in which the body attacks its own cells on its own, taking Methotrexate for rheumatoid arthritis helps to stop the destruction processes and achieve remission.
The cytostatic effect inhibits the growth of connective tissue in the joints, stopping the destruction of cartilage. Methotrexate prevents the further growth of erosion on bone tissue that occurs as a result of impaired maturation of the joint membrane.
The drug Methotrexate for ease of use is available in several forms:
- Tablets containing 2.5 or 10 mg of an active substance.
- 5 ml ampoules containing a solution in a concentration of 50 mg.
- Vials for intravenous administration – the concentration of the active substance is 100 mg / 1 ml.
Indications for use
In addition to treating rheumatoid arthritis, methotrexate is used in the treatment of a number of other diseases:
- Rheumatoid polyarthritis (damage to several groups of joints at once); more about polyarthritis →
- Systemic scleroderma.
- Systemic lupus erythematosus.
- Some forms of leukemia.
- Cancer of the esophagus, kidney, bladder and other types of cancer pathologies.
- Bronchial asthma with the inability to use steroid drugs.
- Nonspecific ulcerative colitis.
- Multiple sclerosis.
It is forbidden to drink methotrexate in the presence of the following contraindications:
- Hypersensitivity to the components of the drug.
- Renal and liver failure.
- Conditions accompanied by immunodeficiency.
- Hepatitis B and C.
- Various forms of anemia.
- Thrombocytopenic purpura.
- Chickenpox or shingles.
- Peptic ulcer of the stomach and duodenum.
- During pregnancy and breastfeeding.
Dosage and administration
Treatment of rheumatoid arthritis with the use of methotrexate is usually carried out using tablet forms of the drug. Injections are indicated only when side effects from the digestive system develop. According to the instructions for use, a single dose of the drug ranges from 6 mg to 26 mg. It is very important that a specialist selects the dosage of Methotrexate – independent uncontrolled use of a medicinal substance can cause significant harm.
Drug therapy always begins with minimal doses, which increase after several weeks of administration. The dose of the drug is increased slowly until the first signs of improvement in the patient’s condition. Methotrexate injections are most often given once a week.
The schedule for taking Methotrexate can vary – from once a week to a single dose every 12 hours. Due to the low probability of remission, the drug should be taken for a long time. The minimum course of treatment is 6 months. According to statistics, positive results after six months of therapy are observed in 60% of patients. To consolidate, it is recommended to continue therapy with Methotrexate for another 2-3 years.
A year after the start of treatment, the risk of complications increases, most often from the gastrointestinal tract, therefore it is important to regularly visit a specialist to monitor the condition of the body.
It is also not recommended to independently decide whether to stop taking the medicine. Withdrawal of methotrexate is carried out in very rare cases when serious side effects develop or the patient has surgery. As a rule, after discontinuation of the drug, rheumatoid arthritis worsens.
What if methotrexate does not help? In such cases, you should consult your doctor for advice – you may need to adjust the dose or choose another way of administering the drug.
Methotrexate is a serious drug, so when it is taken, a number of side effects may occur:
- Hypersensitivity reaction – rash on the body, fever, urticaria, anaphylactic shock.
- From the digestive organs – nausea, vomiting, anorexia, pharyngitis, stomatitis, erosion of the esophagus, bleeding, impaired liver function, cirrhosis, and necrosis.
- From the side of the central nervous system – a change in consciousness, drowsiness, seizures, headaches, dizziness, irritability.
- Urinary organs – cystitis, malfunctioning of the kidneys.
- Organs of childbearing – impaired maturation of sperm and ova, dysmenorrhea, miscarriages, intrauterine developmental anomalies.
- Dermatological problems – rash, acne, blisters, furunculosis, increased sensitivity to ultraviolet radiation, erythema.
- Respiratory organs – pneumonia, the accession of a pulmonary infection.
- Visual system – conjunctivitis, photophobia, various visual impairments, lacrimation.
- Other reactions are general weakness and malaise, increased susceptibility to various infectious diseases.
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