MDElliottMD: home-claude category backfill (parser-claude gap closure)

2026-05-23T10:43:34Z

home-claude category backfill (parser-claude gap closure)

← Older revision		Revision as of 10:43, 23 May 2026
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	== References ==		== References ==
	<references />		<references />
			[[Category:Antifolates]]
			[[Category:DMARDs]]
			[[Category:Antineoplastics]]
			[[Category:Immunosuppressants]]

MDElliottMD: parser-claude batch MedTemplate pre-fill, Top 300 #130

2026-05-23T03:51:55Z

parser-claude batch MedTemplate pre-fill, Top 300 #130

New page

{{MedTemplate
| generic = Methotrexate
| brand = Trexall, Otrexup, Rasuvo, Xatmep, Rheumatrex (discontinued)
| structure =
| classes = [[:Category:Antifolates|Antifolate]], [[:Category:DMARDs|DMARD]], [[:Category:Antineoplastics|Antineoplastic]], [[:Category:Immunosuppressants|Immunosuppressant]]
| uses = <vote slug="rheumatoid-arthritis-use">Rheumatoid arthritis</vote>, <vote slug="psoriasis-psa-use">Psoriasis and psoriatic arthritis</vote>, <vote slug="crohn-use">Crohn's disease maintenance</vote>, <vote slug="ectopic-pregnancy-use">Unruptured ectopic pregnancy</vote>, <vote slug="medical-abortion-use">Medical abortion (in some regimens)</vote>, <vote slug="leukemia-lymphoma-use">Leukemia and lymphoma (high-dose oncology regimens)</vote>, <vote slug="cns-prophylaxis-use">CNS prophylaxis in hematologic malignancy (intrathecal)</vote>
| starting_dose = Rheumatologic: 7.5-15 mg PO or SC '''once weekly''' (not daily — daily dosing is a recognized fatal error); folic acid 1 mg PO daily on non-MTX days; oncology dosing is far higher and indication-specific
| preparations = 2.5 mg tablets; 10-50 mg/mL injection; pre-filled subcutaneous autoinjectors (Otrexup, Rasuvo); 2.5 mg/mL oral solution (Xatmep)
| fda_max = Rheumatologic ~25 mg/week; oncology indication-specific
| pill_id =
| routes = Oral, subcutaneous, intramuscular, IV, intrathecal
| onset = Rheumatologic effect at 4-8 weeks; ectopic resolution over 2-3 weeks
| duration = Once-weekly dosing in rheumatology
| halflife = 3-10 hours (low dose); 8-15 hours (high dose); much longer in third-space accumulation (pleural effusion, ascites)<ref name="trexall-label">FDA Prescribing Information, methotrexate, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/008085s074lbl.pdf</ref>
| bioavailability = 60-70% PO at low doses; saturable at high doses (parenteral routes preferred above 15-25 mg/week)<ref name="trexall-label" />
| pregnancy = '''Contraindicated in pregnancy''' (Category X); abortifacient and teratogenic. Discontinuation 3-6 months before conception is standard.{{citation needed}}
| legal = [[USLegal:Prescription only|Rx-only]] in US
| mechanism = <vote slug="methotrexate-mech-claim">Methotrexate competitively inhibits dihydrofolate reductase, depleting tetrahydrofolate and blocking thymidylate, purine, and amino acid synthesis; in rheumatologic doses the immunomodulatory effect appears mediated less by DHFR inhibition and more by AICAR transformylase inhibition with subsequent adenosine accumulation and anti-inflammatory adenosine A2A signaling.</vote> Folic acid co-supplementation reduces stomatitis, GI, and hepatic toxicity without compromising efficacy. Bone marrow suppression, hepatotoxicity, pneumonitis, and nephrotoxicity (especially with high-dose oncology regimens) are the major adverse effects. Glucarpidase rescues high-dose methotrexate toxicity by cleaving extracellular drug<ref name="trexall-label" />.
}}

== References ==
<references />

Methotrexate - Revision history

MDElliottMD: home-claude category backfill (parser-claude gap closure)

MDElliottMD: parser-claude batch MedTemplate pre-fill, Top 300 #130