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Crohn's Disease Forum » Treatment » Methotrexate » Methotrexate scares the *&[email protected] outta me


04-07-2013, 10:05 AM   #1
superzeeman
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Methotrexate scares the *&[email protected] outta me

Reading the side effects of methotrexate I can say for the first time a drug actually has me nervous as all can be. Has anyone on here taking metho have to quit for the reasons below? I also just found out that I should not drink beer on metho. I am used to a couple beers after work every day and that seems to be way to much risking liver damage. I found that there are 696 drug interactions including tylanol, and most or the depressions/bi-polar drugs I am on. Did my GI really take all this into consideration? Thanks for the info.

See Below:
Methotrexate has been reported to cause fetal death and/or congenital anomalies. Therefore, it is not recommended for women of childbearing potential unless there is clear medical evidence that the benefits can be expected to outweigh the considered risks. Pregnant women with psoriasis or rheumatoid arthritis should not receive methotrexate. (See CONTRAINDICATIONS.)
2.Methotrexate elimination is reduced in patients with impaired renal function, ascites, or pleural effusions. Such patients require especially careful monitoring for toxicity, and require dose reduction or, in some cases, discontinuation of methotrexate administration.
3.Unexpectedly severe (sometimes fatal) bone marrow suppression, aplastic anemia and gastrointestinal toxicity have been reported with concomitant administration of methotrexate (usually in high dosage) along with some nonsteroidal anti-inflammatory drugs (NSAIDs). (See PRECAUTIONS: DRUG INTERACTIONS.)
4. Methotrexate causes hepatotoxicity, fibrosis and cirrhosis, but generally only after prolonged use. Acutely, liver enzyme elevations are frequently seen. These are usually transient and asymptomatic, and also do not appear predictive of subsequent hepatic disease. Liver biopsy after sustained use often shows histologic changes, and fibrosis and cirrhosis have been reported; these latter lesions may not be preceded by symptoms or abnormal liver function tests in the psoriasis population. For this reason, periodic liver biopsies are usually recommended for psoriatic patients who are under long-term treatment. Persistent abnormalities in liver function tests may precede appearance of fibrosis or cirrhosis in the rheumatoid arthritis population. (See PRECAUTIONS, Organ System Toxicity, Hepatic.)
5.Methotrexate-induced lung disease is a potentially dangerous lesion, which may occur acutely at any time during therapy and which has been reported at doses as low as 7.5 mg/week. It is not always fully reversible. Pulmonary symptoms (especially a dry, nonproductive cough) may require interruption of treatment and careful investigation.
6. Diarrhea and ulcerative stomatitis require interruption of therapy; otherwise, hemorrhagic enteritis and death from intestinal perforation may occur.
7. Malignant lymphomas, which may regress following withdrawal of methotrexate, may occur in patients receiving low-dose methotrexate and, thus, may not require cytotoxic treatment. Discontinue methotrexate first and, if the lymphoma does not regress, appropriate treatment should be instituted.
8. Like other cytotoxic drugs, methotrexate may induce "tumor lysis syndrome" in patients with rapidly growing tumors. Appropriate supportive and pharmacologic measures may prevent or alleviate this complication.
9. Severe, occasionally fatal, skin reactions have been reported following single or multiple doses of methotrexate. Reactions have occurred within days of oral, intramuscular, intravenous, or intrathecal methotrexate administration. Recovery has been reported with discontinuation of therapy. (See PRECAUTIONS, Organ System Toxicity, Skin.)
10. Potentially fatal opportunistic infections, especially Pneumocystis carinii pneumonia, may occur with methotrexate therapy.
11. Methotrexate given concomitantly with radiotherapy may increase the risk of soft tissue necrosis and osteonecrosis.
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Last edited by superzeeman; 04-07-2013 at 10:27 AM.
04-10-2013, 05:45 AM   #2
parentnj
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Every drug I see scares me ... actually Ibuprofen says if you have more than 3 drinks a day you risk liver damage if you take it. With MTX I would not drink alcohol since that is a real danger given how hard it is on the liver. I don't know about the other risks in comparison to AZA or 6-MP ... I bet they are similar. I would talk to the GI about your concerns.
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04-11-2013, 08:18 PM   #3
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i was reading about the alcohol too, i only drink socially, but what i've read says the occassional drink doesn't hurt. Iv read about people who drink regularly but i personally wouldnt take that chance.

Also remember ur supposed to be monitored closely while on metho, so if any of the serious side effects were to occur, they'd be caught early in your bloodwork. thats the way i figure it. I had my first dose last week and will be getting monthly blood work.
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05-12-2013, 01:51 AM   #4
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I know I had a little freak out when I saw the side effects as well. I try not to even look into the side effects of drugs anymore because it's so terrifying.

BUT...You have to take this information with a grain of salt though. These companies HAVE to print this stuff for legal reason. You mention Tylenol - I took this alllll the time, my doctor told me it was fine. I was (and still am) on anti-anxiety meds when I was on it, also fine.

This is what my doctor told me when I started Remicade: "You have a better chance of getting hit by a bus tomorrow or dying in a car accident that get these severe side effects". And then she literally brought out this sheet and started listing the odds of all these horrible things that were more likely to happen than the drug side effects. haha.

Like I said, I took methotrexate and was OK, except for being sick to my stomach after taking it. I only stopped because it wasn't working. Also remember you have to do blood tests while on it, so you're being monitored for a lot of these side effects. Hope you feel better
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