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Re: MTX - what else?

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Dawn, judy.... I have looked in all my med books and they say not to exceed 20-25mg of mtx but they don't say why. The stronger doses are used for cancer, leukemia, etc. But it does say to DRINK 2-3 quarts of liquids a day and to eat liberally, beef, chicken, lamb, and pork liver, (uck), asparagus, navy beans, kale and spinach. Any food will reduce the peak metho leve obtained. Folic acid is suggested.

Drugs that may decrease MTX effets:

*digoxin (Lanoxin)

*folic acid

*Dilantin or Cerebyx

Drugs taken with MTX that increase it's effects and enhance it's toxicity:

*asprin

*Diuretics may lowering white blood cells

*NSAID's

*Pirlosec

*Benemid

*Vioxx

Methotrexate taken concurrently with:

*Cordarone may result in MTX toxicity

*Elspar and others may relsut in blunted MTX Activity

*Pepto-Bismol, others may reslut in MTX Toxicity

*Goecillin, other penicillins may lead to mtx toxicity

*Questran,and other cholesterol lowering resins may result in * decreased MTX effectivness

*Bactrim may result in lowering all blood cells

*Cyclosporine can result in increased toxicity from both drugs. This combination should be avoided.

*Doxycycline may result in MTX toxicity

*Tegison results in increased liver toxicity

*Influenzae vaccine (flu)may blunt benefits of the vaccine

*Arava may rsult in liver toxicity

*live virus vaccines ( such as RotaShield) may lead to severe infections

*neomycin may result in decreaseed MTX benefits

*pneumococcal or smallpox vaccine may result in decreased immune response to the vacine

*sulfa drugs, such as sulfamethoxazole, can result in increased hematological toxicity

*tamoxifen (Nolvadex) may increase risk of blood clots

*thiazide diuretics may increase risk of myelosuppression

*Theo-Dur, others may result in theophylline toxicity, decreased theophylline doses may be needed

*Dyazide, others may increase risk of bone marrow problems

*Septra & others may increase risk of toxicity

*yellow fever vaccine can result in blunted response and benefit fromt eh vaccine

This information came from "The Essential Guide to Prescription Drugs 2002" by J. Rybacki, Pharm. D

ladies from what i can find, 25 mg is suppose to be the maxium you can take orally not sure why dawn

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