Methotrexate-Ebeve Solution, syringe, 1 piece, 0.75 ml, 7.5 mg, for injection
Side effect
According to WHO, adverse effects are classified according to their frequency as follows: very common (≥ .1/10), common (≥ .1/100 to less than 1/10), uncommon (≥ .1/1000 to less 1/100), rare (from ≥ .1/10,000 to less than 1/1000), very rare (less than 1/10,000). frequency unknown - based on available data, it was not possible to determine the frequency of occurrence. From the hematopoietic system: often - suppression of bone marrow function (leukopenia, thrombocytopenia, anemia). infrequently - pancytopenia. very rarely - severe progressive depression of bone marrow function, agranulocytosis. frequency unknown - megaloblastic anemia. From the central nervous system: often - drowsiness, headache, fatigue. infrequently - depression, confusion, mood changes. rarely - when using methotrexate in low doses - transient slight impairment of cognitive functions, unusual sensations in the cranial area. very rarely - pain, myasthenia gravis or paresthesia in the extremities, perversion of taste (metallic taste in the mouth), epileptic seizures, meningism, paralysis, insomnia. From the senses: often - visual impairment. uncommon - eye irritation. rarely - conjunctivitis. From the respiratory system: often - chronic interstitial pneumonitis (symptoms indicating potentially serious damage to the lungs with interstitial pneumonitis: dry, unproductive cough, shortening of breathing, increased body temperature). infrequently - alveolitis, pleural effusion. rarely - pulmonary fibrosis, Pneumocystis pneumonia, bronchial asthma. very rarely - pleural pain and thickening of the pleura (when treated with methotrexate in high doses), acute pulmonary edema. From the digestive system: very often - stomatitis, nausea, inflammation of the mucous membranes, loss of appetite, dyspepsia, anorexia, a significant increase in the activity of liver transaminases. often - diarrhea, ulceration of the oral mucosa. infrequently - enteritis, vomiting, liver cirrhosis, liver fibrosis, liver steatosis. rarely - ulceration of the gastrointestinal mucosa. very rarely - malabsorption syndrome, toxic megacolon. From the urinary system: infrequently - inflammation and ulceration of the bladder, impaired renal function, urinary disorders. rarely - renal failure, oliguria, anuria, electrolyte imbalance. From the skin: often - exanthema, erythema, itching. uncommon - photosensitivity, alopecia, herpes zoster, vasculitis, skin rashes herpetiformis, urticaria. rarely - increased pigmentation. very rarely - Stevens-Johnson syndrome, epidermal necrolysis (Lyell's syndrome). When exposed to ultraviolet radiation, increased psoriatic skin lesions, increased pigmentation of nails, acute paronychia, furunculosis and hidradenitis. From the musculoskeletal system: infrequently - arthralgia, myalgia, osteoporosis. From the cardiovascular system: often - vasculitis, bleeding of various locations. infrequently - effusion into the pericardial cavity. rarely - cardiac tamponade, nosebleeds. From the immune system: very often - decreased resistance to infections, pharyngitis. infrequently - hypogammaglobulinemia. rarely - sepsis. very rarely - anaphylactic reactions, increased number of rheumatoid nodules. From the reproductive system: infrequently - ulceration and inflammation of the vagina. very rarely - loss of libido, impotence, oligospermia, menstrual disorders, vaginal discharge. Other: often - chills, malaise, fever, necrosis. rarely - deterioration of wound healing. With intramuscular injection - a burning sensation or tissue damage (formation of a sterile abscess, destruction of adipose tissue) at the injection site. very rarely - benign, malignant and nonspecific neoplasms (including cysts and polyps), lymphomas, which in some cases regress after discontinuation of methotrexate. frequency unknown - diabetes, other metabolic disorders, sudden death. Adverse reactions with intrathecal methotrexate Acute: chemical arachnoiditis, manifested by headache, back or shoulder pain, stiffness of the muscles in the back of the neck and fever. Subacute: paresis (usually transient), paraplegia, impaired cerebellar function. Chronic: leukoencephalopathy, manifested by irritability, confusion, ataxia, muscle plasticity, sometimes convulsions, dementia, drowsiness, coma, in rare cases with death. When combining radiation therapy to the cranial area and intrathecal administration of methotrexate, the incidence of leukoencephalopathy increases.
pharmachologic effect
A group of antimetabolites whose analogue is folic acid . It has an antitumor effect and additionally has an immunosuppressive effect.
The drug slows down DNA repair and synthesis, inhibits cell mitosis. The most sensitive tissues to the effects of Methotrexate are those with the ability to highly proliferate: tumor tissue, embryonic cells, bone marrow, mucosal epithelium.
When the proliferation of cells in malignant tissues exceeds that in normal tissues, Methotrexate leads to disruption of the growth of malignant tumors without harming healthy tissues.
In the treatment of rheumatoid arthritis , the effect is presumably associated with the mechanism of immunosuppression. Methotrexate for rheumatoid arthritis can reduce inflammation and the symptoms caused by it - swelling, pain, stiffness.
In the treatment of psoriasis, Methotrexate acts on plaque keratinocytes, which have an increased growth rate compared to normal skin cell proliferation.
Instructions for use of Methotrexate (Method and dosage)
It is possible to administer Methotrexate Ebeve intramuscularly, intraarterially, intravenously or intrathecally. The tablets are not chewed, take before meals.
The instructions for Methotrexate warn that the selection of doses and treatment regimens for each specific pathology should be carried out strictly in accordance with special literature.
In the case of trophoblastic tumors, up to 30 mg is administered intramuscularly daily for a course of 5 days. Courses are repeated after 1 week until a dose of 400 mg is reached.
Lymphomas and leukemia require intravenous administration of 200-500 mg per m2 once a month.
Neuroleukemia: administered intrathecally 1 – 2 times every 7 days at a dose of 12 mg per m2.
Children are prescribed the following doses:
- under 1 year 6 mg;
- age 1 year – 8 mg;
- up to 2 years use 10 mg;
- over 3 years old, 12 mg is administered.
Methotrexate for rheumatoid arthritis is prescribed starting with a dose of 7.5 mg, once a week. According to indications, the dose is increased, but not more than 20 mg per week.
For psoriasis, a dose of up to 25 mg per week is prescribed, intramuscularly or intravenously.
For mycosis fungoides, administer 50 mg per week once or in 2 doses, intramuscularly.
Reviews of Methotrexate
There are multiple reviews about the drug. Almost all reviews of ectopic pregnancy talk about side effects in the form of severe nausea, abdominal pain, and liver pain. It is imperative to monitor the effectiveness of getting rid of ectopic pregnancy using human chorionic gonadotropin .
Reviews for psoriasis are mostly not very good; many prefer to do without Methotrexate. Patients report that during an exacerbation the drug significantly alleviates the condition, but upon withdrawal it worsens. There are references to cases of toxic hepatitis .
Reviews for rheumatoid arthritis regarding the effect are mostly positive. Persistent remissions on the drug are noted, but at the same time, frequent adverse reactions in the form of nausea are noted. The advantage is that the condition does not worsen upon withdrawal. It is important to observe a gradual increase in dosage when starting therapy. There are also isolated reviews about the low effectiveness of the drug.
Pharmacodynamics and pharmacokinetics
The maximum concentration in the blood of Methotrexate occurs after 30-60 minutes. In patients with leukemia, there may be fluctuations of up to 3 hours.
In blood plasma it binds to albumin. When taken simultaneously with salicylates, chloramphenicols, sulfonamides, tetracyclines, phenytoin, competitive substitution may occur.
Methotrexate does not penetrate the blood-brain barrier; for this it must be administered intrathecally.
The half-life of Methotrexate is about 6-7 hours, in the case of high doses it increases to 17 hours. It is excreted mainly (90%) by the kidneys during the day. About 10% is excreted in bile.
In case of severe renal impairment, excretion is prolonged.
Methotrexate can accumulate in the liver, kidneys and spleen as metabolic products.
Methotrexate price, where to buy
You can buy Methotrexate Ebewe Austria in Moscow for an average of 1,100 rubles. in ampoules. The price in tablets is about 2000 rubles. for 50 tab. dose of 5 mg and 3000 rub. for a dosage of 10 mg.
The price in Ukraine of the drug depends on the volume and quantity in the package and ranges from 200 to 800 UAH.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
LuxPharma* special offer
- Methotrexate Ebewe (Austria) 5 mg 50 pcs
1980 rub. order - Methotrexate Ebewe (Austria) 10mg 50pcs
2900 rub. order
- Methotrexate Ebewe (Austria) 2.5 mg No. 50
1850 rub. order
ZdravCity
- Methotrexate tablets p.p.o. 2.5 mg 50 pcs. Ozone LLC
290 rub. order
- Methotrexate-Ebeve solution for injection. 10mg/ml 5mlEbeve Pharma Ges.m.b.H. Nfg. KG
RUB 201 order
Pharmacy Dialogue
- Methotrexate-Ebewe (solution d/in. syringe 10 mg/ml 2 ml No. 1)EBEWE Pharma
RUB 1,023 order
- Methotrexate-Ebewe (solution d/in. syringe 10 mg/ml 0.75 ml No. 1)EBEWE Pharma
RUR 585 order
- Methotrexate-Ebewe (injection solution 10 mg/ml 1.5 ml No. 1 + auto-protected needle) EBEWE Pharma
RUR 827 order
- Methotrexate (tablet p/o 2.5 mg No. 50) Ozon LLC
RUB 256 order
- Methotrexate-SZ (tab.p.pl/vol. 2.5 mg No. 50 (blister)) Northern Star JSC
220 rub. order
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Pharmacy24
- Methotrexate Ebewe 10 mg No. 50 tablets EBEVE Pharma Ges.m.b.H.Nfg.KG, Austria/Haupt Pharma Amareg GmbH (“in bulk”), Germany
801 UAH.order - Methotrexate Ebewe 5 mg No. 50 tablets EBEVE Pharma Ges.m.b.H.Nfg.KG, Austria/Haupt Pharma Amareg GmbH (“in bulk”), Nimeczina
612 UAH. order
- Methotrexate-TEVA 100 mg/ml 10 ml solution
662 UAH. order
- Methotrexate-TEVA 25 mg/ml 2ml solution for injection
123 UAH order
- Methotrexate Ebewe 2.5 mg No. 50 tablets EBEVE Pharma Ges.m.b.H.Nfg.KG, Austria/Haupt Pharma Amareg GmbH (“in bulk”), Nimeczina
335 UAH. order
PaniPharmacy
- METHOTREXATE tablets Methotrexate Ebeve tablets. 2.5 mg No. 50 Austria, Ebewe Pharma
359 UAH. order
- METHOTREXATE tablets Methotrexate Orion tablets. 2.5 mg No. 100 Finland, Orion
349 UAH order
- METHOTREXATE bottle Methotrexate solution for injection 100 mg/ml bottle 10 ml No. 1 Netherlands, Pharmachemie
721 UAH. order
- METHOTREXATE tablets Methotrexate Orion tablets. 2.5 mg No. 30 Finland, Orion
173 UAH order
- METHOTREXATE tablets Methotrexate Ebeve tablets. 10 mg No. 50 Austria, Ebewe Pharma
834 UAH. order
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Indications for use
- trophoblast tumors;
- neuroleukemia;
- non-Hodgkin's lymphoma , incl. lymphosarcoma ;
- acute leukemia (myeloblastic and lymphoblastic);
- osteogenic soft tissue sarcoma;
- skin cancer , lung cancer , breast cancer , squamous cell cancer, genital cancer (male and female), bladder cancer, esophageal cancer , kidney cancer, medulloblastoma, retinoblastoma;
- severe stages of mycosis , psoriasis ;
- arthritis , systemic lupus erythematosus, dermatomyositis , ankylosing spondylitis .
Methotrexate analogues
Level 4 ATX code matches:
Methoject
Vero-methotrexate
Main analogues:
- Vero-Methotrexate
- Methotrexate Teva
- Methodject
- Methotab
Which is better: Methotrexate or Methoject?
When compared with regular Methotrexate, some call Methoject more effective, but if it is Methotrexate Austria Ebewe, it is the Austrian drug that is characterized by good effect and purity, i.e. with fewer side effects. The prices of the medications are practically the same.
Contraindications
- severe damage to the kidneys and liver;
- alcoholism;
- severe infectious diseases ( tuberculosis , HIV infection );
- history of pathology of the hematopoietic system;
- vaccinations with live vaccines;
- history of gastrointestinal and oral ulcers;
- taking large doses of the drug with acetylsalicylic acid;
- breastfeeding period and pregnancy ;
- individual intolerance.
Methotrexate is prescribed cautiously for kidney and liver damage, obesity , suppression of bone marrow hematopoiesis, diabetes mellitus , use of hepatotoxic drugs before treatment, infectious diseases of bacterial, viral, fungal origin, ascites , peritoneal and pleural effusion, dehydration, herpes zoster , previous contact with patients with herpes simplex, with measles , chickenpox , strongyloidiasis , amebiasis , with gout or urate nephrourolithiasis , with infections and inflammatory processes of the oral mucosa, ulcerative colitis, peptic ulcer, vomiting, diarrhea, gastrointestinal obstruction, aciduria , asthenia , chemotherapy or radiation pretreatment therapies in elderly patients and children.
Interaction
With alcohol abuse and taking hepatotoxic drugs, the toxic effect of Methotrexate on the liver increases.
Concomitant use with Leflunomide increases the incidence of pancytopenia and cases of hepatotoxicity.
Chloramphenicol and Tetracycline when administered orally reduce the absorption of Methotrexate.
Ciprofloxacin , glycopeptides , Penicillin , loop diuretics, Phenylbutazone - reduce the clearance of the drug in the kidneys, which increases its concentration in the blood and increases toxicity to hematopoiesis.
Also, the toxicity of Methotrexate increases when used simultaneously with salicylates and non-steroidal anti-inflammatory drugs.
Chloramphenicol , sulfonamides, pyrimethamine have a negative effect on the bone marrow, so combined use with Methotrexate aggravates hematological disorders.
Trimethoprim and sulfamethoxazole , which cause folate deficiency, as well as lipid-lowering drugs and indirect anticoagulants can enhance the toxic effect of Methotrexate.
Increased consumption of coffee, tea and sweetened drinks with caffeine should be avoided during treatment, as the clearance of theophylline .
When taken simultaneously with cytostatics, the clearance of Methotrexate is reduced.
Combination with radiotherapy increases the likelihood of tissue necrosis.
Methotrexate suppresses the immune response to vaccination, and in the case of live vaccines, severe antigenic reactions are likely.
Taking Amiodarone can cause skin ulcers.
With the introduction of Acyclovir and the simultaneous use of intrathecal Methotrexate, the risk of neurological damage is increased.