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

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Patients treated with methotrexate should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice. Pregnant women with psoriasis or rheumatoid arthritis should not receive methotrexate (See CONTRAINDICATIONS). Methotrexate elimination is reduced in patients with impaired renal function, ascites, or pleural effusions. 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. MANAGEMENT: The use of methotrexate in combination with other potentially hepatotoxic agents (e. 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. His only other medications were amlodipine (5 mg per day) and methotrexate (15 mg per week). Methotrexate has been reported to cause fetal death and/or congenital anomalies.

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