Brand name: methotrexate
Generic name: Emthexate, MTX, Rheumatrex, amethopterin, Methoblastin

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In patients receiving concomitant methotrexate, the incidence was 6% compared to 26% with Humira monotherapy. Antibodies developed in 12% of patients on adalimumab monotherapy and in 1% of patients on concurrent methotrexate. MANAGEMENT: The use of methotrexate in combination with other potentially hepatotoxic agents (e. Patients treated with methotrexate should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice. No interference occurs, however, if methotrexate is measured by a radioimmunoassay (RIA). Duration of leucovorin administration varies with the dosage of methotrexate and plasma concentrations achieved (including rate of elimination); in general, leucovorin administration is continued until methotrexate concentrations fall to less than 5 � 10 -8 Molar. Alkalinization of urine (with bicarbonate and/or acetazolamide) and intravenous hydration (1000 mL per square meter of body surface area over six hours prior to beginning the methotrexate infusion and 3000 mL per square meter of body surface area per day during the methotrexate infusion and for two days after the infusion is completed) are also important to prevent renal toxicity caused by methotrexate and/or its metabolites. It works like folic acid in the body, which helps to reduce the action and toxic effects of folic acid antagonists (eg, methotrexate). Taking methotrexate and alcohol together may increase the risk of liver injury. Necrotizing fasciitis resulting in death has been reported in a 54-year-old man with rheumatoid arthritis receiving infliximab every 8 weeks along with intramuscular methotrexate weekly dosage.

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