Methotrexate

Immunosuppressant

Indications

Severe CD and maintenance of remission in adults and children 7-17 years old. Monitor blood tests as per local and/or national guidelines.

Contraindications

UC; ulcerative stomatitis; active infection; ascites; immunodeficiency syndromes; significant pleural effusion; photosensitivity; dehydration; severe blood disorders; active peptic ulceration. Caution in older patients. Avoid during pregnancy or while breastfeeding, hepatic impairment and severe renal impairment. Advise full blood count and renal and liver function tests before starting treatment. | Potential side effects: Anaemia; reduced appetite; diarrhoea; drowsiness; fatigue; headache; gastrointestinal discomfort; increased risk of infection; oral disorders; low white blood cell and platelet count; throat complaints; skin reactions; vomiting; nausea; chest pain; cough

Preparations Available

Oral tablet, subcutaneous injection

Quantity

Dose: Initially 25mg once weekly, reducing to 10–25mg once weekly in remission (prescribe folic acid to reduce side effects)

Sizes Available

2.5mg tablets (28), £1.62; 10mg (100), £55.07; 7.5mg/0.15ml solution for injection pre-filled pens/syringes (1), £12.87; 7.5mg/1ml solution (1), £13.37; 10mg/0.2ml solution (1), £11.25; 12.5mg/0.25ml solution (1), £12.34; 15mg/0.3ml solution (1), £14.41; 17.5mg/0.35ml solution (1), £15.25; 10mg/0.4ml solution (1), £15.56; 22.5mg/0.45ml solution (1), £16.11; 25mg/0.5ml solution (1), £16.13; 22.5mg/0.45ml solution (1), £16.50; 30mg/0.6ml solution (1), £16.56