Choriocarcinoma, chorioadenoma destruens & hydatidiform mole. In acute lymphatic leukemia, as prophylaxis of meningeal leukemia & as maintenance therapy in combination w/ other chemotherapeutic agent. Meningeal leukemia. Breast cancer, epidermoid cancers of the head & neck, advanced mycosis fungicides & lung cancer, particularly squamous & small cell type. In combination therapy, advance stage non-Hodgkin's lymphomas. Symptomatic control of severe, recalcitrant, disabling psoriasis.
Dosage/Direction for Use
Choriocarcinoma & similar throphoblastic disease 15-30 mg daily IM for 5 days. Repeat 3-5 times w/ rest period of ≥1 wk. Breast carcinoma 40 mg/m2 IV on the 1st & 8th days. Leukemia 3 mg/m2 in combination w/ prednisone 60 mg/m2 given daily, usually w/in a period of 4-6 wk. Meningeal leukemia 8-12 mg/m2 or 200-500 mcg/kg by intrathecal inj at intervals of 2-3 days & is usually repeated until cell cone of CSF returns to normal. Psoriasis 7.5-25 mg/wk single IM or IV dose.
Contraindications
Hypersensitivity. Patients w/ psoriasis or RA w/ alcoholism, alcoholic liver disease, preexisting blood dyscrasias. Pregnancy & lactation.
Special Precautions
Renal impairment, ascites, pleural effusions. Close monitoring of bone marrow, liver, lung & kidney toxicities.
Decrease responses w/ vit prep containing folic acid or its derivatives. Folate deficiency state may increase MTX toxicity. Increased bone marrow suppression w/ trimethoprim/sulphamethoxazole.
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