Unitrexate (50mg) 2ml, 10 Vial Injections

Methotrexate injection primarily exerts its therapeutic effects through the inhibition of dihydrofolate reductase (DHFR), an enzyme crucial for the synthesis of folic acid derivatives. By blocking DHFR, methotrexate disrupts the production of tetrahydrofolate, which is essential for the synthesis of purines and pyrimidines, key components of DNA and RNA. This inhibition impairs the proliferation of rapidly dividing cells, particularly those with high metabolic activity, such as cancer cells and immune cells involved in inflammatory processes. The drug's cytotoxic and immunosuppressive properties contribute to its effectiveness in treating various cancers and autoimmune disorders by suppressing cell growth and modulating immune responses.

Antimetabolite

injection

The following are the uses of Methotrexate injection:

• Used for treating certain types of cancer, such as leukemia, lymphoma, and osteosarcoma.
• Used for managing severe psoriasis and rheumatoid arthritis by slowing the growth of skin cells and suppressing the immune response.
• Used for controlling autoimmune conditions like Crohn's disease and lupus, where it helps regulate an overactive immune system.
• Used for managing ectopic pregnancies to stop the growth of the embryo.
• Used for treating severe cases of asthma, reducing inflammation in the airways.
• Used for treating certain types of brain tumors, especially in combination with other chemotherapy drugs.
• Used for managing severe cases of multiple sclerosis, helping to reduce disease activity.

In the case of an overdose of Methotrexate injection, prompt medical intervention is necessary. Symptoms may include gastrointestinal issues, such as nausea, vomiting, and diarrhea, as well as potential damage to the bone marrow and liver. It is crucial to seek emergency care, where treatment will focus on supportive measures and managing the patient's symptoms. Timely action can help mitigate the severity of the overdose and its potential long-term effects.

In the case of a missed dose of Methotrexate injection, it is important to consult your healthcare provider for specific instructions. Generally, if you remember within a few hours of the missed dose, you can take the injection as soon as possible. However, if it's almost time for your next scheduled dose, it is best to skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one, as this may increase the risk of side effects. Always inform your healthcare provider if you miss a dose, especially if it occurs frequently.

To administer the Methotrexate injection, clean the injection site with an alcohol wipe, insert the needle at a 90-degree angle, and slowly inject the medication as directed by your healthcare provider, ensuring the entire dose is delivered under the skin.

Following are the conditions/situations when Methotrexate injection should not be administered:

• Must not be used in individuals with a known allergy to Methotrexate or any of its ingredients.
• Contraindicated in pregnant and breastfeeding women.
• Should not be used in patients with severe kidney or liver disease.
• Not recommended for individuals with active infections or those with a compromised immune system.
• Avoid in patients with significant bone marrow suppression or blood disorders.
• Contraindicated in patients with active peptic ulcer disease or gastrointestinal bleeding.
• Should not be used in individuals with severe lung disease or breathing difficulties.
• Not suitable for those with a history of alcohol abuse or liver damage caused by alcohol.
• Avoid in patients with a history of severe or uncontrolled diabetes.

The side effects of Methotrexate injection may include:

• Nausea and vomiting
• Mouth sores or ulcers
• Hair loss or thinning
• Skin rash or itching
• Fatigue and weakness
• Diarrhea
• Increased risk of infections

Following are the precautions and warnings:

• Methotrexate injection should be used with extreme caution in patients with impaired liver function, as it is primarily metabolized by the liver, and dosage adjustments may be necessary.
• Regular monitoring of liver function is essential during treatment, and if liver disease is present or develops, therapy should be discontinued.
• Patients with pre-existing renal impairment or those receiving nephrotoxic drugs should be closely monitored, as methotrexate can cause renal toxicity.
• This medication is contraindicated in individuals with a known hypersensitivity or severe allergic reaction to methotrexate or any of its components.
• Methotrexate is a potent drug and should be used with caution in elderly patients, as they may be more susceptible to its toxic effects due to reduced kidney function.
• Patients should be advised to maintain adequate hydration and avoid alcohol consumption during treatment to minimize potential toxicity.
• Women of childbearing potential must use effective contraception while on methotrexate treatment, as it can cause severe birth defects or fetal death if taken during pregnancy.
• Methotrexate injection should be used with caution in patients with compromised immune systems, as it can further suppress immune responses.

Following are the drug interactions for Methotrexate injection:

• Probenecid and nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the elimination of methotrexate, increasing its toxicity risk.
• Trimethoprim/sulfamethoxazole may increase methotrexate levels, requiring dose adjustments.
• Antibiotics like penicillins and cephalosporins can decrease methotrexate excretion, leading to increased methotrexate concentrations.
• Co-administration with retinoids (e.g., acitretin) can enhance methotrexate's toxicity, especially in the liver.
• Theophylline levels may be increased by methotrexate, necessitating monitoring and potential dose reduction.
• Live vaccines should be avoided during and after methotrexate therapy due to potential immune system suppression.
• Proton pump inhibitors (PPIs) like omeprazole can decrease methotrexate elimination, requiring careful monitoring.

Following are the food interactions to be aware of when taking Methotrexate injections:

• Avoid alcohol consumption during and after treatment to reduce potential liver damage and minimize side effects.
• Folic acid supplementation is recommended to counteract the potential depletion caused by Methotrexate.
• Maintain a balanced diet with adequate fluid intake to support overall health and kidney function during treatment.
• Avoid high-dose vitamin supplements, especially those containing folic acid, unless prescribed by your doctor.
• Avoid grapefruit and grapefruit juice as they may interfere with Methotrexate metabolism.
• Limit or avoid black and green tea, as they may decrease the effectiveness of Methotrexate.
• Consult your healthcare provider for specific dietary recommendations and adjustments during Methotrexate therapy.

Methotrexate injection should be stored in a secure and designated area, preferably in a cool and dry environment, maintaining a temperature between 68°F and 77°F (20°C and 25°C). Protect the medication from light and moisture to ensure its stability and effectiveness. Always keep it in its original packaging or a properly labeled container to avoid misuse. When disposing of unused or expired methotrexate injection, it is crucial to follow local guidelines and regulations. Do not dispose of it in regular household trash or pour it down the drain. Contact your healthcare provider, pharmacist, or local waste management authorities for instructions on safe disposal methods to prevent environmental contamination. Keep this medication out of the reach of children and pets to prevent accidental exposure.

Following are the quick tips for Methotrexate injection:

• Methotrexate injection is usually given by a healthcare professional, ensuring proper administration.
• Ensure you inform your doctor about all your medical conditions and medications.
• During treatment, stay well-hydrated and maintain a balanced diet.
• Avoid alcohol consumption as it may increase potential side effects.
• Regular blood tests are essential to monitor liver and kidney function.
• If you experience any unusual symptoms, contact your doctor immediately.
• Store the medication as directed, away from children and pets.