Methotrexate in rheumatoid arthritis
Methotrexate in rheumatoid arthritis prescribed to relieve the patient from excruciating pain. This disease belongs to the group of chronic autoimmune disorders, which occur in inflammatory processes in the joints. Periarticular tissues are also gradually affected, the structural changes include the ligaments and muscles. The joints become inflamed, they arise from neoplastic processes.
As the dynamic development of the disease produces redness. The disease is in the progressive mode, periods of exacerbation alternate with temporary remissions. In the period of acute pain much worse, and for their reduction doctors prescribe the treatment of rheumatoid arthritis methotrexate.
To use methotrexate in rheumatoid arthritis allowed only for medical purpose. With the purchase of the drug in the pharmacy should immediately check whether the package instructions for use. To avoid purchasing poor quality or expired medicines, you can ask the pharmacist to show a certificate.
For the treatment of various diseases produce finished vials of methotrexate. Bottles of prepared solutions contain, in addition to the main ingredient, water, sodium chloride, sodium hydroxide. The tool is used for subcutaneous or intravenous injection is an intramuscular injection, intra-arterial, intrathecal (via implanted pump). Instructions for use sold together with the drug attached to the original packaging.
Drugstores offer other forms of the drug.
|Vials with solutions.||Capacity 1000, 50, 20, 5мг.|
|The vials with powder.||Are available capacities of 100, 50, 10, 5 mg.|
|Pills.||Contain of 2.5, 5 or 10 mg of methotrexate.|
|Concentrates for the manufacture of solutions for infusion.||1 ml contains 100 mg of the substance.|
Tablet form is less suitable for treatment. Oral substitute injection, if the gastrointestinal tract is formed side effects after pill. The recommended the pill is made of either a half hour after eating or one hour before a meal.
The dosage prescribed only by a doctor. An experienced therapist to oversee the process of concentration of the active component of substances in the composition of blood plasma. At the initial stage of treatment the dosage is determined by the amount of 7.5 mg one-time admission for a week. Let’s say a triple dose with a 12 hour interval. The most suitable dosage form for a particular patient chooses the physician. It also determines the duration of the upcoming patient treatment.
The treatment can be several months or half a year. Terms are defined taking into account the severity of rheumatoid arthritis, the patient’s age, underlying diseases, the intensity of relapses.
How do the medicines
Rheumatoid arthritis refers to diseases that are not possible to cure completely. Therefore, in modern medicine is practiced the appointment of a specially designed treatment methods. In the course of their application:
- improves vital functions of the joints;
- reduces inflammation;
- preventing of disability.
It is very important to consult a doctor promptly. If in the early stages to start applying the medication increased the chances of favorable future Outlook. Condition which prescribed methotrexate for rheumatoid arthritis is only suspected, is in the early stages, disease has passed into the chronic form. At any stage of the disease the drug is having effective assistance. But it is important to choose dosage form, the dosage. Instructions for use of medication contains all necessary information about the indications and contraindications, dosage forms release and permissible dosages of reception.
Decided to order 2 main types of medications in the treatment of arthritis:
- anti-inflammatory drugs quick action;
- modifying basic medicines slow the action.
The action of basic drugs based on prevent or slow down the destructive processes in the joints. That is the basic group of drugs can cause a period of remission. Methotrexate belongs to the category of basic medicines to the group of antimetabolites antagonists of folic acid. It violates the synthesis of DNA, RNA, causes the death of harmful cells, slowing the growth, division, and hinders the development of malignant tumors. The drug is active in the tissue from which the most sensitive cells of the mucous membrane of the oral cavity and intestinal epithelium, embryonic stem cells, the cell structure of the bladder, bone marrow.
For successful treatment it is important to select the dose. This should only be done a specialist who knows the individual characteristics of the patient.
Indications and contraindications
Common medical cases, when the effective methotrexate rheumatoid arthritis in primary, acute or chronic stage, acute leukemia, a cancer of the skin, lymphosarcoma, psoriasis. The appointment would do if diagnosed with breast cancer, lung tumor, cancer of the esophagus, cervix and vulva. Effective method of methotrexate in germ cell tumors of testicular, ovarian, bladder, kidney, squamous cell carcinoma of the head and neck, neuroleukemia, retinoblastoma, medulloblastoma. The drug is prescribed to treat severe forms of psoriasis, Ewing’s sarcoma, osteosarcoma, sarcomas of soft tissues, of mycosis fungoides. The indications include CNS involvement, non-Hodgkin’s leukoma, cancer of the penis.
Situations when you don’t prescribe methotrexate rheumatoid arthritis on a background of chronic severe infections, blood dyscrasia, alcohol abuse, hepatic or renal failure. Usage instructions prohibits the drug to pregnant women due to teratogenic properties of the composition, nursing mothers. You cannot use this medicine for people with peptic ulcer disease of the gastrointestinal tract, patients with hepatitis, tuberculosis, AIDS. Don’t prescribe methotrexate to the patient, if he have an individual intolerance or hypersensitivity to the individual components or ingredients.
Do not attempt to adjust the dose on your own. Overdose of this drug causes very dangerous effects and complications.
Possible side effects
When high efficiency of this medication is noted a large number of related complications. Side effects can be associated with the duration of administration, individual intolerance of the organism, the previously existing diseases of other Genesis, the simultaneous reception of this and other drugs. Among the side effects of methotrexate are headaches, drowsiness, convulsions, conjunctivitis or blindness.
The reception of this tool can cause fibrosis or cirrhosis of the liver, anorexia, venous thrombosis, severe nephropathy. Sometimes the patient rises in liver transaminases occur pharyngitis and gingivitis, the possible States of apathy, anorexia. Frequent cases of gynecomastia, rash erythematous, erosive plaques appearance, respiratory failure, alveolitis. People with weak immune systems may develop acute hepatitis, allergic vasculitis, toxic epidermal necrolysis, pulmonary fibrosis. Among the particularly hazardous effects of soft tissue necrosis, anaphylactic shock, massive sepsis, cryptococcosis, diabetes mellitus, pulmonary embolism, sudden death.
In order to avoid side effects and harmful consequences of the wrong treatment, the treatment should done under strict medical supervision. Before prescribing medication, a number of diagnostic procedures.
Preparation for treatment
If your doctor has prescribed this medication, take it immediately. Before treatment activities are being prepared. The patient passes a common detailed analysis of the blood, and the doctor examines her figures to confirm his appointment. Laboratory monitoring includes identification of key indicators (platelets, leukocytes, erythrocytes). Patient check liver function, assess the level of AST, ALT, serum albumin, bilirubin. Checking kidney function involves performing procedures ultrasound or x-ray, functional examination, assessment of glomerular filtration rate. Patients tested 1 or 2 times per month.
The doctor comprehensively an individual checks the condition of the body, looking for possible contraindications. The starting dose is assigned based on state of health, individual anatomy, activity flow of the inflammatory process. If there are no contraindications, you can start the course of treatment. If you have side effects, the drug is canceled. Constant current control is conducted throughout the entire period of the course basic therapeutic treatment.
Taking methotrexate in rheumatoid arthritis, the desired effect can be expected until two weeks after the start of treatment. The wait can be longer, it depends on many individual factors. Medical practice have noted cases of occurrence of positive dynamics in six weeks after the start of therapy are shown.