Talk:Methotrexate

Untitled
GUYS, THIS IS NOT A FUCKING FORUM TO DISCUSS METHOTREXATE. COMMENTS IN REGARDS TO THE ARTICLE QUALITY ONLY!!!

my personal review
1/10 would not recommend while it might cure cancer or slow arthritis, this stuff is disgusting. avoid — Preceding unsigned comment added by 199.172.169.97 (talk) 14:19, 17 June 2016 (UTC)

May be an aggressive drug, but can improve the lives of those suffering greatly. I know someone who uses this and would not be here without the drug as it has improved their life so much that they want to live now. Rjis21 (talk) 03:32, 8 December 2021 (UTC)

would someone sort the 'history' section please
The basic mistake in the history section is that it's talking about aminopterin, not methotrexate. The story of Sidney Farber is fascinating, but not correct as written.

This part of the article needs to be edited heavily, along with the aminopterin article, to be consistent with reference 1, http://www.fasebj.org/cgi/content/full/16/3/273e, and with the history at Dana-Farber, http://www.dana-farber.org/abo/news/publications/pop/fall-winter-2007/seizing-the-moment_2.html Meheller (talk) 23:43, 16 October 2009 (UTC)

After further thought, I took this section out:

History
Methotrexate originated in the 1940s when Dr. Sidney Farber at Children's Hospital Boston was testing the effects of folic acid on acute leukemic (severe blood cancer) children. Inspired, he asked Dr. Y. Subbarao, then Director of the Research Division of Lederle Labs (part of American Cyanamid), to synthesize the anti-folate (methotrexate). Dr. Subbarao, who also happened to be the head of the team which had earlier synthesized folic acid (1946) readily synthesized this anti-folate and handed it over to Dr. Farber, who in turn administered it to a small group of very ill leukemic children. The remarkable clinical improvement that was observed in these patients heralded the era of cancer chemotherapy in modern medicine. This was reported by Dr. S. Farber in the June 3rd, 1948 issue of NEJM. In 1950 Dr. Farber founded in Boston the world's first Cancer Research Center. Methotrexate gained Food and Drug Administration (FDA) approval as an oncology drug in 1953.

Meheller (talk) 14:52, 17 October 2009 (UTC)

Cambridgeshire incident
I removed the link to the Cambridgeshire incident. Close reading of the document linked reveals that there is no support for the claims made. In that incident, a woman (who normally received 17.5 mg of MTX per week) was put on 10mg a day by her general practicioner, leading to severe complications and death. This has nothing to do with the weekly dosing! The toxicity was due to the 70mg weekly dose!!! JFW | T@lk  11:57, 31 May 2004 (UTC)

Naming
I want to bring to subject that aminopterin isnt the same as methotrexate. The brand name of methotrexate is Amethopterin. Aminopterin is Purinethol, and was used as a very toxic chemotherapeuticum for the treatment of acute leukemia. I know this because im working on a medicall article, in which we discuss old chemotherapeutica.


 * Thanks, I'll correct it. Your work sounds very interesting. Would you mind also editing the relevant Wikipedia articles (e.g. nitrogen mustard)? You seem to have the expertise to say something useful; classical references are also extremely welcome! JFW | T@lk  17:49, 14 March 2006 (UTC)


 * And on the subject of naming, a quick look through several editions of Martindale leads me to think that "amethopterin" is a deprecated synonym for methotrexate derived from its chemical name, rather than a trade name. I'll update the main page to reflect this. -Techelf 09:09, 18 April 2006 (UTC)


 * Actually, Aminopterin is not Purinethol. Purinethol is the trade name for 6-mercaptopurine, a structurally unrelated antimetabolite also used in the therapy of patients with leukemia.  Aminopterin (4-aminopteroic acid) is the antifolate first used by Farber to induce remissions among patients with leukemia.  Although more potent than methotrexate, it was replaced by methotrexate in the 1950s, due to unpredictable toxicity.  Now in a more pure preparation, aminopterin is back in clinical trials for patients with leukemia.
 * Above posted by User:130.219.235.253 15 May 2006

Methotrexate and Cancer Treatment (Question)
Hi, just a quick question about the common use of Methotrexate in various types of cancer treatment... what is the purpose of inhibiting the metabolism of Folic Acid? By that I mean, what is the reasoning? -- Is it to somewhat control the cancerous cell replications?

Thanks
 * —Preceding unsigned comment added by 142.145.80.43 (talk • contribs) 15:38, 10 August 2006

folic acid >> dihydrofolate >> tetrahydrofolate which is necessary for the synthesis of thymidine, an essential nucleotide that is a component of DNA. Inhibiting TMP synthesis will result in no more DNA synthesis and cancer cells will die. — Preceding unsigned comment added by 109.151.67.220 (talk) 19:25, 22 January 2012 (UTC)

Patent Number
Does anybody know what the original US patent number is for methotrexate?

Why is it necessary to take folic acid with methotrexate??
'''Methotrexate inhibits Folic Acid reductase which is responsible for the conversion of Folic Acid to tetrahydrofolic acid. At two stages in the biosynthesis of ppurins and at one stage in the synthesis of Pyrimidines, one-carbon transfer reactions occur which require specific coenzymes synthesized in the cell from tetrahydrofolic acid.''' —The preceding unsigned comment was added by 194.170.95.77 (talk) 11:40, 4 February 2007 (UTC).

Folic acid versus folate
This article starts by talking about Methotrexate and folic acid, but then slips in a reference to folate with no explanation. It would be good if folate were explained as (copied from the Folic Acid article) the anion version of folic acid. —The preceding unsigned comment was added by Dtgriscom (talk • contribs) 03:34, 8 February 2007 (UTC).

ones just the oxidised form of the other

it use to treat choriocarcinoma —Preceding unsigned comment added by 41.252.63.21 (talk) 14:04, 27 July 2008 (UTC)

Adverse reactions can be deadly.
My mother took this drug for psoriasis, and after a short term on it (a few months) developed a persistent cough, which grew bad enough that they put her in a medically-induced coma, and ultimately determined that the lung damage was extensive enough for no hope of recovery and the decision was made to take her off life support. While the adverse reactions do include mention of lung issues, I'm not sure they are clear enough about how severe those reactions can be. --198.162.133.115 (talk) 20:04, 11 August 2008 (UTC)

by-effects
The article should contain more information about possible by-effects. At least all of the ones that are mentioned in the info that comes with the medication. there are a lot more than mentioned here! also there probably are some kind of statistics about the effectiveness. in some cases methotrexate doesn't help at all, however sometimes using Enbrelalngside Methotrexate can give very good results. 81.198.141.238 (talk) 23:12, 13 January 2009 (UTC)

There is no mention of elevated lung functions, cytopenias, or pneumonitis that are the most important of the adverse drug reactions — Preceding unsigned comment added by 220.237.38.217 (talk) 04:25, 3 September 2011 (UTC)

Behcet's disease
There is currently an unreferenced paragraph under "Other Uses" about the use of this medication in treating Behcet's disease, I would very much like to know where this information comes from (it sounds like there should be reference to a journal or a study somewhere?).Another anonymous me (talk) 13:10, 5 June 2010 (UTC)
 * Unfortunately there are a lot of things in the article that don't yet have proper sourcing. If you have pointers to good information please let us know. AliveFreeHappy (talk) 03:00, 11 September 2010 (UTC)

Can i drink beer while on Methotrexate
Can i drink beer while on methotrexate —Preceding unsigned comment added by 219.74.58.159 (talk) 11:25, 25 September 2010 (UTC)


 * If you're looking for a proffesional opinion, Wikipedia isn't the place to ask, but in my opinion, I wouldn't recommend it.--Plasmic Physics (talk) 23:02, 25 September 2010 (UTC)

nodue to risk of hepatic toxicity — Preceding unsigned comment added by 109.151.67.220 (talk) 19:26, 22 January 2012 (UTC)

One beer per week is OK per my GP. — Preceding unsigned comment added by 89.177.68.54 (talk) 20:59, 1 August 2012 (UTC)

Usage in a CNN video
I'm not sure if it is noteworthy or not, but this article appears to have been used in a video on CNN's website.--Rockfang (talk) 00:16, 9 February 2011 (UTC)

Structures, mode of action
The structures in the comparison of dihydrofolic acid & methotrexate are both missing an amino at the left side. The block of purine biosynthesis is not caused by loss of reduced folates but by the accumulation of dihydrofolates which inhibit AICAR transformylase (Journal of Biological Chemistry Vol. 262 p. 13520). This is pure speculation, but the resulting increase in AICAR level by a factor of 2-3 might contribute to methotrexate's anticancer activity (see Cell Vol. 144 p. 499). 69.72.27.74 (talk) 03:33, 29 April 2011 (UTC)

This article cites that methotrexate works by allosterically inhibiting DHFR. However, the wiki article on DHFR states that Methotrexate is a competitive inhibitor- as do most other resources that I'm investigating right now. Anyone want to correct this? — Preceding unsigned comment added by 24.155.185.195 (talk) 05:34, 27 December 2011 (UTC)

Methotrextrate... same as Methodextrate?
Methodextrate has no page. I have no expertise in this subject but it appears to me that the two drugs may be one and the same. Both names are often used equivalently (do a google search) but that is no guarantee.

If the drugs are indeed identical could someone please organise a re-direct? If not then a page should be created for Methodextrate. There is certainly a drug of this name supplied in Australia and it appears to be for the same symptoms. Pawprintoz (talk) 10:49, 26 October 2011 (UTC)

Lupus
An IP editor recently added lupus to the list of disorders that methotrexate is used to treat. This appears to be true, but it's unclear if the existing references support this statement or not. Can anybody confirm? – RobinHood70 talk 23:58, 24 November 2011 (UTC)

methotrexate
How long does it stay in your system after you quiet taking it?(debbie5505) — Preceding unsigned comment added by Debbie5505 (talk • contribs) 20:46, 6 March 2012 (UTC)

Not long--it's eliminated from the bloodstream pretty quickly. 2604:2000:C6A1:B900:E5E2:46DF:8FA:7693 (talk) 03:33, 25 May 2015 (UTC)

Dosage errors / seriousness of complications.
In the UK, patients on methotrexate (MTX) are given a booklet produced by the National Patient Safety Agency and it mentions that there have been problems with patients being given the wrong dosages as the different strength tablets look similar. It notes that some hospitals now only use the 2.5 mg tablets to prevent such problems. Patients on MTX have to have regular blood tests, and the results are recorded in the aforementioned booklet. It is also noted that patients are usually only given this drug by hospitals, not general practitioners / family doctors. Whilst the drug is safe for many, there must be significant risks for such a cautious approach to prescribing it. Basically, what I am trying to say is that the risks seem to be somewhat downplayed in this article. Also the degree of supervision required, plus the attention given to it by the NPSA should be mentioned.

Personally, MTX has been the most effective treatment for my arthritis I have taken and I continue to use it, but like all things medical, comprehensive information is vital and people should be fully aware that taking this drug is a pretty big deal compared to other meds. I don't feel I have the medical knowledge / sources to add/amend relevant sections, so am posting here in the hope that someone more qualified than I will do so. — Preceding unsigned comment added by 80.6.102.83 (talk) 22:19, 24 September 2013 (UTC)

References Could Be Better
There seems to be a poor use of references available on the internet for this *med*. A few have felt a need for better information of the adverse/side affects for methotrexate. I am in complete agreement, especially since at least one reference used in this article, jumps to a website that requires an individual to "sign up/sign into" in order to utilize their guide/reference book material. I am unsure exactly what we are expected to be able to access; I pesonally refuse to sign up for any website via Wiki just to follow up on a reference. It's my understanding, that Wiki *expects* all articles to have legitimate, easily clickable links to view any references.

So, I am changing at least one link included in the article, that linked several items to one reference#. The new referenced website will be drugs.com which seems to have actually followed the *insert* thats made available with methotrexate-based upon the wording that was used for drugs.com's info page for this wonderful *ahem* drug.

If I sound a bit hazy, I just checked my internal and computer chronometer and it's 5:17am and I have not been to bed to get much needed sleep, (I guess its obvious being on here reading this article I have cause to not sleep). If anyone has cause to believe my work is not up to Wiki standards(however each individual sees things their own way), please be my guest and brush up whatever seems to need doing.

≈≈an hour and a half later and I am much the worse for wear-the references utilized in this article seem to cater to the pharmaceutical, creating quite a headache while attempting to retrieve ref#3,5,17 and 19. It is also my belief that the section titled "Adverse Effects" needs to be retitled "Side Effects". Within the scope of reviewing information regarding this drug, the use of the phrase 'side effects' was utilized instead of 'adverse':

≈≈Drug interactions are also frightening, and this article barely scratches the surface. According to drugs.com there are a total of 765 drugs (3474 brand and generic names) which are known to interact with methotrexate, and breaks down as: 188 major drug interactions (759 brand and generic names), 547 moderate drug interactions (2634 brand and generic names), 30 minor drug interactions (81 brand and generic names) and last but certainly NOT least, caffiene and alcohol are expressley prohibited.

≈≈If anything a reference link that is attached to both sections to drugs.com should be used-that website encourages its participation in other websites and blogs, with guidelines exactly how to properly write any citations from drugs.com.

≈≈A serious rewrite needs to be done to this article so that its as inclusive/conclusive as possible, with reference links created that do not require the continual clicking onto links by Wiki users when they follow up on references.

69.249.125.97 (talk) 09:35, 29 July 2015 (UTC)BrattySoul

Overdose
Should include information on leucovorin and glucarpidase rescue. ― Bio chemistry 🙴 ❤   21:37, 21 May 2017 (UTC)

methotrexate interaction with lefulonamide and clonazepam
pl elobrate above — Preceding unsigned comment added by 106.204.236.199 (talk) 15:45, 4 July 2018 (UTC)

It has a role in treating dermatological diseases?
Methotrexate is commonly prescribed off label to treat atopic dermatitis. This use, is not illegal but it has been debated (see the talk page for ivermectin) whether we should mention it in the lead of the Wikipedia entry for the drug. An unwritten rule would be to only mention the uses indicated by FDA approvals, which would mean that we do not mention in the lead that Methotrexate is commonly prescribed off label to treat atopic dermatitis. What are your thoughts on this dilemma? Forich (talk) 04:18, 10 November 2021 (UTC)

Methotrexate
Is it better to take at night or morning? And do I take all 6 pills at once or split up during the day 2600:8806:8100:BA6:85C5:56C9:7AF3:64D (talk) 02:40, 23 November 2021 (UTC)

Let's add "anti-inflammatory"
The possible mechanisms by which this medicine works could be made clearer. One patient taking it says plainly that "it reduces inflammation." Can we put that into the article? Only the footnotes plainly refer to inflammation. Instead the text has indirect phrasing "treatment of rheumatoid arthritis" over and over. A source says "Mechanism(s) of action in rheumatoid arthritis not known; suggested mechanisms have included immunosuppressive and/or anti-inflammatory effects." I'm not a specialist and don't want to make an assertion but if that's even a likely path it would be a relief to read the plain hypothesis. -- econterms (talk) 03:07, 5 April 2022 (UTC)