Brand name: methotrexate
Generic name: Emthexate, Methoblastin, MTX, amethopterin, Rheumatrex

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Antibodies developed in 12% of patients on adalimumab monotherapy and in 1% of patients on concurrent methotrexate. May aid in identifying patients with delayed methotrexate clearance; toxicity appears to be related at least as much to the length of time that methotrexate concentrations are elevated as to the peak concentrations achieved. Her RA had been treated with methotrexate (10 mg per week) and bucillamine (200 mg per day) for 6 years. Such patients require especially careful monitoring for toxicity, and require dose reduction or, in some cases, discontinuation of methotrexate administration. Cutaneous lesions partially remitted following infliximab discontinuation and methotrexate treatment. Alkalinization of urine (with bicarbonate and/or acetazolamide) and intravenous hydration (1000 mL per square meter of body surface area over six hours prior to beginning the methotrexate infusion and 3000 mL per square meter of body surface area per day during the methotrexate infusion and for two days after the infusion is completed) are also important to prevent renal toxicity caused by methotrexate and/or its metabolites. Patients treated with concomitant methotrexate had a lower rate of antibody development than patients on Humira monotherapy (1% versus 12%). Taking methotrexate and alcohol together may increase the risk of liver injury. This indicates that NSAIDs may enhance the toxicity of methotrexate. MANAGEMENT: The use of methotrexate in combination with other potentially hepatotoxic agents (e. Methotrexate, especially at higher doses or with prolonged treatment, has been associated with hepatotoxicity including acute hepatitis, chronic fibrosis, necrosis, cirrhosis, and liver enzyme elevations.

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