â€¢ Central Nervous System:
Dizziness, fatigue, headache, language disorder, weakness, paresis, convulsions, destruction of the myelin sheaths (IV after cranio spinal irradiation), inflammation of the arachnoid (a covering of the brain), transient paresis, nerve damage.
â€¢ Skin: Redness of the skin, rashes, itching, loss of hair, hives, photosensitivity, pigmentary changes, skin discoloration, dilatation of blood vessels, acne, furunculosis, aggravation of psoriasis by ultraviolet light, severe allergic reactions.
â€¢ Eye and ENT: Blurred vision, inflammation of the gums, inflammation of pharynx.
â€¢ Gastrointestinal: Nausea, vomiting, enteritis, mouth ulcer, diarrhea, abdominal distress (common), loss of appetite, blood in vomit, blood in stool, GI ulceration and bleeding.
â€¢ Genitourinary: Renal failure, blood contains excess amount nitrogen, inflammation of the urinary bladder, blood in urine, severe kidney disease, reproductive disorders, infertility, abortion, fetal defects.
â€¢ Blood: Deficiency of all three blood cell types, bone marrow depression, anemia, bleeding, presence of bacteria in the blood (septicemia).
â€¢ Liver: Elevated LFTs (liver function test), liver damage.
â€¢ Respiratory: Deaths from interstitial pneumonia, chronic interstitial obstructive lung disease.
â€¢ Miscellaneous: Malaise, chills, fever, lower resistance to infections, joint pain, muscle pain, diabetes, osteoporosis, allergic reactions, sudden death.
Oral Burkitt's lymphoma- 10-25 mg/day for 4-8 days, repeat after 7-10 days.
Oral & IMChoriocarcinoma(Ectopic Pregnancy)- 15-30 mg/day for 5 days, repeat after an interval of at least 1 week for 3-5 courses.
Mycosis fungoides- 2.5-10 mg/day to induce remission.
Rheumatoid arthritis- 7.5 mg once weekly, adjust if needed. Up to 20 mg/wk.
Crohn's disease- 12.5-22.5 mg once weekly for up to 1 year.
PO/IV/IM- Psoriasis- 10-25 mg once wkly, adjust subsequent doses if needed.
IV- Osteosarcoma- 12-15 g/m2 as infusion, followed by folinic acid.
Breast cancer 10-60 mg/m2 often with cyclophosphamide and fluorouracil. Advanced lymphosarcoma Up to 30 mg/kg, followed by folinic acid rescue. Acute lymphoblastic leukaemia Maintenance: 2.5 mg/kg every 14 days.
It comes as a tablet to take by mouth, with or without food.It also comes as a solution for injection to be administered by a healthcare provide into a large muscle.
It should not be administered during breast feeding. It should also not be used in patients allergic to the drug, pregnancy, liver disease, in alcoholics, people with low blood counts or decreased immunity.
â€¢ Caution should be exercised in patients with liver or kidney problems, blood disorders, diarrhea, and stomach problems.
â€¢ If vomiting or diarrhea occurs, you will need to take care not to become dehydrated.
â€¢ It may cause liver or kidney impairment, bone marrow depression, ulcerative disorders of the GI tract.
â€¢ Avoid become pregnant while taking this medication.
â€¢ Monitor hematological, renal and hepatic function and GI toxicity regularly.
â€¢ Avoid drinking alcohol while you are taking this medication.
Do not take medicines containing aspirin, ibuprofen or folic acid while taking this medication.
Store intact vials at room temperature (15-25Ã¯Â¿Â½C). Keep this medication in an airtight container.
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