CYTOTREXATE Tablet Oral Uses Side-effects Dose Over-dose in Urdu
It is Used For Different diseases.
CYTOTREXATE Tablet Oral Uses
CYTOTREXATE Tablet Oral Uses
It is in a class of medications called antimetabolites.
Cytorexate treats cancer by slowing the growth of cancer cells.
It treats psoriasis by slowing the growth of skin cells to stop scales from forming.
It is indicated for the management of acute lymphoblastic leukemia.
In combination with corticosteroids, cytotrexate has been used to induce remission,
it is effective in the treatment of choriocarcinoma and other trophoblastic tumors and is used, often in combination with other antineoplastic agents, in the treatment of a variety of malignant diseases including lymphosarcoma Burkitt’s lymphoma, osteogenic sarcoma, and tumors of the bladder, brain, breast, cervix, head, and neck, lungs, ovaries, and testis,
cytotrexate is of value in the treatment of psoriasis but because of the risk associated with this use,
it should only be given when the disease is severe and not responded to other forms of treatment.
CYTOTREXATE Tablet CONTRA-INDICATIONS:
Cytotrexate is contraindicated in pregnancy; in the treatment of psoriasis of patients in a poor state of nutrition, serious renal or liver disorders; bone marrow hyperplasia, leucopenia, thrombocytopenia or anemia Cytotrexate should not be used in pregnant women or fertility women who could become pregnant, unless the potential advantages outweigh the risk of the fetus, Absorption, mortality of the fetus and/or congenital anomalies have taken place in women receiving Cytotrexate especially in the first three months of pregnancy. Mothers must not nurse during Cytotrexate therapy.
CYTOTREXATE Tablet Side-EFFECTS:
CYTOTREXATE Tablet Side-EFFECTS
- abdominal cramps,
- ulceration of the mouth, rectum, or vagina,
- the onset of bone marrow depression with anemia,
- leucopenia and thrombocytopenia may occur.
- An increased tendency to fractures of the long bones may occur in patients on long-term treatment with Cytotrexate.
Regular hemoglobin estimations and white cell and platelet counts are required during Cytotrexate therapy. Signs of toxicity such as mouth ulceration, gastrointestinal disturbances, or onset of bone marrow depression will necessitate modification of the dose. The undesirable effects of Cytotrexate on the bone marrow and the gut may be minimized by administering the drug in a large intermittent dose rather than daily. As Cytotrexate is excreted through the kidney the presence of impaired renal function will aggravate the toxic action of the drug. Cytotrexate therapy should be withdrawn immediately if there is a Severe infection. Cytotrexate should be used with extreme caution in the presence of infection, peptic ulcer, ulcerative colitis, debility, and in extreme youth and old age.
The oral dose for acute lymphoblastic leukemia is 3.3 mg. Cytotrexate per M2 of body surface daily in combination with 40-60 mg. Prednisolone per M2 of body surface daily for 4-6 weeks. After remission is attained a maintenance dosage is 20-30 mg/M2 of body surface orally twice a week.
2.5 -10 mg a day orally for several weeks or months. Initial dose and follow-up doses are determined by patients’ response and hematological monitoring.
In Burkitt’s Tumors; stage l-ll, the recommended dosage is 10-25 mg per day orally for 4-8 days. In this stage, all Cytotrexate is given concomitantly with another anti-tumor agent. Treatment in all stages may respond to combined drug therapy with Cytotrexate given in doses of 0.625mg to 2.5mg/kg body weight daily.
An initial test dose of 5-10mg given parenterally one week prior to initiation of Cytotrexate therapy is recommended to detect any idiosyncrasy. Following are starting dose schedules.
1. Divided oral dosage schedule based on cellular kinetic studies: 2.5 mg at 12 hours intervals for four doses each week; weekly dose should not exceed 30mg.
2. Daily oral dosage schedule: 2.5mg daily for five days followed by at least two days rest period; daily dosage should not exceed 6.25mg.
3. Weekly single oral schedule: 10-25 mg orally once a week until a favorable result is obtained. With this dosage schedule, 50mg per week should ordinarily not be exceeded. Dosage in each dosing schedule to achieve optimal clinical response. After optimal clinical results have been reached to the longest possible rest period. Methotrexate topical therapy should be restarted as soon as possible.
ANTIDOTE FOR OVERDOSAGE:
Calcium folinate is a potent agent for neutralizing the immediate toxic effects of Cytotrexate 3-6 mg calcium folinate should be administered as soon as possible, preferably within one hour, but no later than 4 hours, since calcium folinate is usually not effective after a longer period. Where large doses or overdosage are given calcium folinate may be given by intravenous infusion in doses up to 75mg. Within 12 hours, followed by 12 mg .intramuscularly every 6 hours for four doses. If average doses of Cytotrexate produce a toxic effect, 6-12 mg of calcium folinate can be given intramuscularly every 6 hours for 4 doses.
Generally, in case of overdosage,
the dose of calcium folinate should be equal to or higher than the offending dose of Cytotrexate and should be administered within the first hour.