metotrexato (MTX) is a medicine used in the treatment of the psoriasis, rheumatoid arthritis (AR), psoriática arthritis, the dermatomiositis and some other diseases. In the beginning this medicine was used to treat different types from cancer, but at that time a high dose of which it is used nowadays, for the treatment of the AR was used much more.
The metotrexato has been used by more than 25 years in the treatment of rheumatoid arthritis, and in 1988 by FDA was approved in EE.UU (Food And Drug Administration), for its use in the AR of the adult.
The metotrexato alters the form in which the organism uses the folic acid, that is necessary for the cellular growth. Also it has effect like anti-inflammatory. By these two actions the MTX is beneficial in the treatment of the AR. This medicine belongs to the called medicine group: therapies of 2ª line or modifiers of rheumatoid arthritis (DMAR). These medecines can diminish the activity of the AR in a degree greater than aspirina and another antiinflammatories nonsteroids (AINES). Commonly the metotrexato one in association with the AINES. Generally it begins to act to the 3 weeks, but it can sometimes delay up to 3 months to reach his maximum effectiveness.
The metotrexato benefits a high percentage from these patients and as well it is tolerated commonly is used in the therapy of the AR, in association with another antiinflammatories. It diminishes the number of painful joints and fans in Rheumatoid Arthritis.
The oral MTX takes everything in a single dose generally although sometimes if it is wanted are possible to be separated the doses and to take 2 or 3 times in 24 h, but always only once for week. Example: you can in the evening take all the medicine in the days Monday, or take half from the medicine in the morning of Monday and the rest in afternoon. Other times a day is even taken two parts and the rest in the morning of the following one, in this case divides to Monday and another part Tuesday. This is made generally in Psoriática Arthritis, since in this disease this form of treatment has more effect. In the AR it seems to give the same turn out to take it everything in a single taking, whenever there are not important indirect effect, like nauseas and vomits. Also the Metotrexato can be given in subcutaneous or intramuscular injection. The injectable route in people is used who are not responding to the dose by oral route or because they present/display stomach nauseas or annoyances. The MTX is not taken more frequently than a day to the week, since if it is taken more frequently it can produce serious secondary phenomena. It is necessary to take the medicine the same day every week not to be mistaken. A good idea is to mark in the calendar when the dose has been taken thus to make sure and not to be mistaken. In case of doubt he is better not to take the medicine and to call to the doctor.
It calls immediately to his doctor if it develops cough, progressive difficulty to breathe or fever. One of the problems most frequent is the possibility of hepatic damage, that it is detected with blood examinations. This is little frequent when low doses like the used ones for rheumatoid arthritis are used, unless the person drinks alcohol. By this it is necessary to avoid the consumption to regulate of spirits while the treatment with Metotrexato lasts.
Note: it is essential to become the examinations of laboratory in the dates that to him his doctor indicates and to return to consult the doctor in regular form, since many of these indirect effect can be detected precociously before serious and sometimes mortal complications are developed. The indirect effect indicate that it is necessary to change the dose or to suspend the medicine.
. He learns more on the Metotrexato. He discusses east medicine with his doctor. He takes only the amount prescribed by his doctor. It remembers that this medicine is taken only once per week. It does not stop becoming the examinations of laboratory in the indicated date and it does not lack to the appointments with his doctor. It does not take other medecines when it is taking Metotrexato without asking his doctor to see if there are contraindications. If another doctor prescribes another medicine to him adviértale that is taking MTX. They do not have to take Sulfas when Metotrexato is taken. The Sulfas is used generally for the urinary infections and generally they have other names of fantasy (like Bactrimel) and so sometimes it is difficult to identify them.
She knows that she can have a folic acid deficit when You this taking MTX, are by this your doctor perhaps suggests to him to take folic acid every day. The folic acid can diminish the occurrence of buccal ulcers, annoyances gastrointestinal, diarrhea, headaches and even problems in the hemogram that can appear with the MTX. It does not drink alcohol. It communicates the doctor to him if You have: - Allergies to other medicines. - If it is taking other medicines including vitamins or other medecines bought without prescription. - If it has other medical problems, especially of the kidney, liver or lung. Any vaccine without being in agreement with its doctor is not put. The MTX can diminish the resistance of their organism and perhaps You have problems with the vaccine.
If You have influenza or if she has other infections she calls to his doctor quickly to see if she must continue taking Metotrexato during this disease. The dehydration (loss of flowed) can increase the risk of indirect effect.
Like other medecines, the use of MTX in rheumatoid Arthritis is not guarantee of which he will be effective for all the people. In spite of this, the majority of the Rheumatologists agrees in which when the MTX is used in appropriate form the benefits surpass greatly to the possible indirect effect. Conver with his doctor and it discusses the different alternatives from treatment of his disease. The communication between UD and its doctor is extremely important.
Loa cases that do not respond to a taken good treatment with MTX can be dealt now with new medecines that are excellent, but more expensive. Between these they are Leflunomide (ARAVA) and the Etanercept that is Anti-Factor de Necrosis Tumoral (ENBREL). Another medicine with mechanism similar to the Enbrel is Infliximab (REMICADE). This it is by endovenosa route and it is necessary to use it in association with MTX.
In experimental form in EE.UU a procedure similar to the called dialysis is used in some refractory cases to all other type of treatment (PROSORBA). This it allows to remove of the blood compound the antigen-antibody harmful to the organism.
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