Methotrexate
Methotrexate is a medication that has been used effectively to treat rheumatoid
arthritis and psoriasis. Because of this success, an open trial was conducted
in 14 Crohn's patients and seven ulcerative colitis patients who had not
responded to other medical therapies. More than 70 percent of the patients
improved. Although none of the colitis patients achieved remission, more than
one-third of the Crohn's patients did. Subsequent randomized clinical trials
demonstrated that methotrexate was beneficial both for treatment of active
Crohn's disease and for maintenance of remission; however, a benefit in
ulcerative colitis has still not been demonstrated.
Methotrexate may work more rapidly than azathioprine and 6-MP, which can
require three to six months before symptoms lessen. In this study, most
Crohn's patients who responded to the drug improved by eight to 10 weeks.
In a larger, placebo-controlled trial, people with chronically active Crohn's
received weekly methotrexate injections. Corticosteroids could be reduced or
eliminated while inducing remission in these patients. Methotrexate pills have
not been as effective as injections.
Toxicity is an important issue that limits methotrexate use in many patients.
Side effects are most commonly "flu-like symptoms": nausea, vomiting, fatigue
and diarrhea. However, serious side effects involving the bone marrow,
liver, and, rarely, the lungs also have been reported. Methotrexate
causes fetal death and congenital abnormalities. Thus, if either partner is
receiving methotrexate, couples must avoid pregnancy for at least three
months after the drug is stopped (for men), or after one full ovulation cycle
(for women). If a woman becomes pregnant while on methotrexate, termination
of the pregnancy is advised, if this is consistent with her beliefs.
Women should not breastfeed while taking methotrexate.
On behalf of learning, and use as teaching tools for those of us who need to
know about our disease, I have tried to supply you with as much information as
I could find on all of the drugs, treatments and disorders associated with
Inflammatory Bowel Diseases. I have tried to blend all facts supported by research
and also from personal experiences of other IBD sufferers into one readable webpage, and any and all information presented here is not entirely
from one source. Most information contained within these pages is found in the public domain.
At times you may find information used from another site, and as with all copyrighted materials you may find on these pages, I claim fair use under sections 107 through 118 of the Copyright Act (title 17, U.S. Code). Click here for more info
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