Methocel 2.5 Tablet

Description of Methocel 2.5 (Methotrexate 2.5 mg) tablet

Methotrexate, Methocel 2.5 tablet, is an antinoplastic drug being a folic acid antagonist, which is a member of the antimetabolite group of drugs. It finds extensive application in treating different types of cancers and also in the treatment of autoimmune disorders. The drug depends on the interference of the process of cell division in tumour cells with a high rate of growth and in this process, it inhibits the growth of tumour cells. The cancer cells are more vulnerable to this mechanism since they divide at a very high rate. Nevertheless, there is a rapid division of normal cells like bone marrow and the lining of the gastrointestinal tract that might also be affected, resulting in side effects.

Indications of Methocel 2.5 (Methotrexate 2.5 mg) tablet

Methocel 2.5 is used in the treatment of Acute lymphoblastic leukemia (ALL) is a type of lymphoblastic leukemia, which is characterized by proliferation of small, white blood, and short-lived lymphocytes, Non-Hodgkin lymphoma, Osteosarcoma, and Breast cancer. It is also applied in rheumatoid arthritis and psoriasis.

Mechanism of action of Methocel 2.5 (Methotrexate 2.5 mg) tablet

Methotrexate prevents the activity of an enzyme dihydrofolate reductase (DHFR) that is needed to produce tetrahydrofolate. This is a key required compound in the production of purines and thymidylate to replicate DNA. Methotrexate prevents division of cells by inhibiting this pathway and causes cancer cells to die due to high rate of division.

How to consume Methocel 2.5 (Methotrexate 2.5 mg) tablet

Methocel is an oral tablet. The dose is determined according to the body surface or administered as weekly dosing according to the condition. The precise schedule should be observed since toxicity may be severe with wrong dosing (particularly in the daily rather than weekly dosage).

Side Effects of Methocel 2.5 (Methotrexate 2.5 mg) tablet

1. Common side effects

• Nausea
• Vomiting
• Fatigue
• Mouth ulcers
• Loss of appetite

2. Serious side effects

• Bone marrow suppression
• Hepatotoxicity
• Pulmonary toxicity
• Severe infections

3. Rare side effects

• Renal toxicity
• Hypersensitivity reactions

Safety Advice for Methocel 2.5 (Methotrexate 2.5 mg) tablet

Methotrexate is a drug that may impact on several organs hence patients are expected to be closely monitored by conducting regular blood counts, liver functioning tests, and kidney functioning tests. Toxicity is commonly treated with folic acid supplementation.

Breastfeeding: Methotrexate has no contraindications in relation to breastfeeding because it may be transferred to the breast milk and damage infant cells that are rapidly dividing.

Pregnancy: The drug is contraindicated during pregnancy because it causes severe abnormalities in foetuses as well as miscarriage because of its impact on the DNA synthesis.

Alcohol: alcohol should be avoided as it puts one at high risk of liver damage when used together with Methotrexate.

Liver: Liver patients are susceptible to hepatotoxicity and thus liver enzymes monitoring is necessary.

Lungs: Cough, breathlessness or chest pains should also be reported because Methotrexate may result in pneumonitis.

Kidney: Renal function is to be observed, since the poor functioning of kidney may result in the development of drug accumulation and severe toxicity.

Driving: Patients might feel fatigued or dizzy therefore driving should not be done in case of such symptoms.

Interaction of Methocel 2.5 (Methotrexate 2.5 mg) tablet

• Drug–Drug Interaction

Ibuprofen × Methotrexate

NSAIDs could interfere with renal clearance of Methotrexate resulting in elevated drug clearance and higher likelihood of toxicity.

Methotrexate × Trimethoprim / Sulfonamides.

The drugs add effects of antifolates and raise the chances of major bone marrow suppression.

Omeprazole × Methotrexate

May lower the excretion of Methotrexate and raise the toxicity.

Penicillins × Methotrexate

May reduces the renal excretion resulting in the need to accumulate the drug.

Leflunomide × Methotrexate

Compared, the risk of liver toxicity is much higher when the two are administered.

• Drug–Food Interaction

Food does not largely interfere with the absorption of Methotrexate but alcohol is to be strictly avoided since it is at risk of causing liver damage.

• Drug–Disease Interaction of Methocel 2.5 (Methotrexate 2.5 mg) tablet

Liver disease:
Methotrexate has hepatotoxic effects and patients with underlying liver disease are highly exposed to the development of severe hepatotoxicity.

Bone marrow disorders:

The medication inhibits the action of the bone marrow, thus predisposing one to anaemia, infections, and bleeding.

Renal impairment:

Decreased renal clearance can result into build up of Methotrexate and toxicity.

Pulmonary disease:

Methotrexate can induce lung toxicity in the form of pneumonitis particularly in lung conditions that are already present.

Contraindication of Methocel 2.5 (Methotrexate 2.5 mg) tablet

Should not be used during pregnancy, during severe liver disease, severe renal impairment, bone marrow suppression, and hypersensitivity.

Dosage of Methocel 2.5 (Methotrexate 2.5 mg) tablet

The condition is used to give out dosage based on body surface area or weekly dosing. Change in dose depends on patient response and toxicity.

Storage of Methocel 2.5 (Methotrexate 2.5 mg) tablet           

Keep at room temperature in a moist-free and heat-free environment and do not leave in the hands of children.

Missed Dose of Methocel 2.5 (Methotrexate 2.5 mg) tablet

In case of dose omission, then it ought to be taken immediately unless it is near the next dose. There should be no cases of doubling the doses.

Other General Information of Methocel 2.5 (Methotrexate 2.5 mg) tablet

Patients are to be properly hydrated and strictly adhere to medical recommendations. To cheque side effects, it is necessary to follow up regularly. Fever, mouth ulcers, difficulty in breathing are some of the symptoms that should be reported.

FAQs of Methocel 2.5 (Methotrexate 2.5 mg) tablet

1. What is the rationale of combining folic acid with Methotrexate?

The use of folic acid minimises side effects like mouth ulcers and bone marrow supression without any effect on its anticancer properties.

2. Is Methotrexate hepatotoxic?

Yes, particularly long-term use or alcohol consumption hence normal monitoring is very important.

3. Why do we want to dose on a weekly basis?

Methotrexate is very toxic when taken in a daily dose rather than weekly, thus it is important to be strict to adhere to it.

4. Is it possible that Methotrexate will influence the lungs?

Yes, it can produce pneumonitis, and any respiratory symptoms can be reported at the earliest.

5. Are frequent monitoring and reviews necessary?

Yes, blood counts, liver, and renal function tests are mandatory to safe treatment.

Fact Box of Methocel 2.5 (Methotrexate 2.5 mg) tablet

References

• FDA Prescribing Information – Methotrexate
  https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/011719s127lbl.pdf
• European Medicines Agency (EMA) – Methotrexate Product Information
  https://www.ema.europa.eu/en/documents/product-information/methotrexate-epar-product-information_en.pdf
• DrugBank – Methotrexate
  https://go.drugbank.com/drugs/DB00563
• National Cancer Institute (NCI) – Methotrexate
  https://www.cancer.gov/about-cancer/treatment/drugs/methotrexate