Methoget 50 Injection

Description of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Methotrexate, Methoget Injection 50 mg is an antineoplastic drug belonging to an antimetabolites group, and an antagonist of folic acid. It has many applications in management of different cancers and autoimmune diseases. The medication disrupts the process of DNA replication in the quickly growing cells thus suppressing the growth of the tumor. Cancer cells are more susceptible to its action since they are known to divide rapidly. Nonetheless, toxicity can be caused by the normal rapid proliferating cells like those of the bone marrow and gastrointestinal lining. The high dose therapy and where drug control delivery is necessary is preferred in injectable form.

Indications of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Methotrexate, Methoget Injection 50 mg is an antineoplastic drug belonging to an antimetabolites group, and an antagonist of folic acid. It has many applications in management of different cancers and autoimmune diseases.

Mechanism of action of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Methotrexate inhibits the activity of the enzyme dihydrofolate reductase (DHFR) and it inhibits the synthesis of tetrahydrofolate required to synthesize DNA and RNA. This results in the cell division inhibition and death of cancer cells which multiply rapidly. It is active most in the S-phase of the cell cycle.

How to consume Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Methotrexate injection can be intravenously, intramuscularly, subcutaneously or intrathecally depending on the indication. It is given in cycles and is dependent on the body surface area. Leucovorin rescue, hydration, and alkalinizing of urine are needed in high-dose therapy.

Side Effects of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

1. Common side Effects

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

2. Serious side Effects

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

3. Rare Side Effects

• Skin rash
• Hypersensitivity reactions
• Alopecia
• Secondary malignancies

Safety Advice for Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Patients under Methoget Injection must be monitored closely and blood counts, liver function tests as well as renal function tests must be performed regularly since the drug may influence several organ systems. The dose should be changed according to the toxicity and response of the patient.

Breastfeeding: Methotrexate should not be administered when breastfeeding because it can enter the breast milk, and harm the infant.

Pregnancy: Not recommended due to teratogenicity, and deformity in fetus and miscarriage.

Alcohol: There should be no alcohol consumption since it exposes the liver to high chances of toxicity.

Liver: Liver disease patients are vulnerable to hepatotoxicity; liver enzyme monitoring should be done frequently.

Lungs: Methotrexate may result in interstitial pneumonitis, which is characterized by cough, fever, and dyspnea, emergency treatment is needed.

Kidney: Renal function has to be carefully observed since a defective clearance may cause the corrosion of the drug and serious toxicity. High doses are used in the treatment of hydration and alkalinization of urine.

Driving: Patients may be tired or dizzy and driving must not be done in case of the symptoms.

Interaction of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

• Drug–Drug Interaction

Diclofenac × Methotrexate
NSAIDs reduce the blood flow in kidneys and reduce excretion of Methotrexate. This results in drug build up in the body and exposes one to extreme toxicity especially that of bone marrow and gastrointestinal toxicity.

Trimethoprim × Methotrexate

When they are used together they have a synergist effect that leads to severe bone marrow suppression, pancytopenia and risk of infections.

Pantoprazole × Methotrexate

These medications may lead to renal clearance of Methotrexate being decreased, especially in large doses that result in increased plasma levels and toxicity, including nephrotoxicity, mucositis.

Penicillins × Methotrexate

Penicillins reduce the excretion of Methotrexate in tubules of the kidneys, which builds up and is too much.

Leflunomide × Methotrexate

The two drugs are hepatotoxic. The combination is of high risk of liver damage and the liver enzymes should be closely monitored.

Cisplatin × Methotrexate

Cisplatin can also lead to the damage of the kidneys, thereby slowing down the hepatic clearance of Methotrexate and increasing toxicity, especially nephrotoxicity and myelosuppression.

Live Vaccines × Methotrexate

Methotrexate weaken the immune system, hence, live vaccines can cause severe infections.

• Drug–Food Interaction

Food does not affect Methotrexate injection. Nonetheless, alcohol should be avoided at all costs because of the higher chances of liver damage. To avoid kidney toxicity, adequate hydration is crucial.

• Drug–Disease Interaction of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Liver disease:

Methotrexate is mostly metabolized in liver. The drug may build up and result in severe hepatotoxicity (including fibrosis and cirrhosis) in patients with preexisting liver disease. The danger is also enhanced with prolonged usage. The liver functions should be regularly checked.

Bone marrow disorders:

Methotrexate causes a reduction in the activity of bone marrow and hence the production of red blood cells, white blood cells and platelets. This can be increased in patients who have bone marrow suppression and lead to severe anemia, infections and bleeding complications.

Renal impairment:

Methotrexate is secreted through the kidneys. The chronic kidney disease causes reduced drug clearance and retention, which causes severe toxicity (bone marrow suppression and mucositis). The dose and hydrate needs to be changed.

Pulmonary disease:

Methotrexate can cause a potentially very severe lung disease, interstitial pneumonitis. Individuals that have lung disease are at greater risk. The symptoms that include dry cough, fever and breathlessness should be evaluated.

Gastrointestinal disorders:

Methotrexate causes mucositis and ulceration of GI tract by killing the rapidly dividing cells. This could be acute and lead to eating difficulties and risk of infection in patients with preexisting GI disorders.

Contraindication of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Pregnancy, acutely damaged liver, massive damaged renal functions, bone marrow defect, active infection, hypersensitivity.

Dosage of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Pregnancy, acutely impaired liver, large-scale impaired renal functions, bone marrow suppression, active infection, hypersensitivity.

Storage of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Store in the room temperature, without light or moisture.

Missed Dose of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Give under the supervision as soon as possible. Do not double dose.

Other General Information of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Keep hydrated, strictly adhere to dosing regimen and regularly follow up. Immediately report fever, ulcer or difficulty breathing.

FAQs of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

1. What is the rationale behind leucovorin rescue with Methotrexate?

Leucovorin is a source of reduced folate which circumvents DHFR inhibition, sparing normal cells to toxicity and allowing Methotrexate to proceed with its anticancer activity on rapidly dividing cells.

2. Why is Methotrexate very toxic in overdose?

Due to its mechanism of inhibiting the synthesis of DNA in all cells with a rapid rate of division, overdose may cause serious bone marrow suppression, mucosal injury, liver disease, and even death unless it is corrected on time.

3. What is the importance of kidney functioning in the course of treatment?

Methotrexate is eliminated via the kidneys. In case of kidney dysfunction, the drug retains in the body, becoming toxic. This is prevented with hydration and alkalinization of urine.

4. Does Methotrexate have long term complications?

Yes, there is a risk of liver fibrosis, lung damage and long-term bone marrow suppression when used without proper monitoring.

5. What is the reason why blood tests are done regularly?

To check the functionality of the bone marrow and to detect the initial symptoms of toxicity including the low number of blood cells to make changes in doses in time.

Fact Box of Methoget Injection 50 mg (Methotrexate 50 mg/2 mL) injection

Field	Details
Generic Name	Methotrexate
Therapeutic Class	Anti-neoplastic agent
Pharmacological Class	Antimetabolite (Folate antagonist)
Dosage form	Injection
Habit forming	No
Indication	Leukemia, lymphoma

 

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