What You Need to Know About Methotrexate

甲氨蝶呤是在20世纪40年代开发的，以治疗儿童白血病。在20世纪80年代中期，使用安慰剂管制的几项研究证明了这一点methotrexate could also be an effective treatment for RA。Methotrexate quickly received U.S. Food and Drug Administration (FDA) approval to treat RA and came to be considered the standard of care by the early 1990s. Up to90 percent of people with RA have taken methotrexate在他们的治疗职业生涯的某些方面。

You might feel anxious when you hear that methotrexate a chemotherapy drug. Many drugs work for more than one condition and in different doses. When used to treat RA, methotrexate is given in doses that are 100 times less than what is used to treat cancer. This medication has been used for autoimmune arthritis for three decades and is considered one of the safest medications, with a few caveats which will be discussed later in this slideshow.

风湿病学家通常会在口服甲氨蝶呤上启动你开始剂量每周往往是每周7.52至10毫克。那是三个或四个小片。甲基药物最多需要三个月来真正开始工作。如果它没有控制您的症状以及您的医生希望，通常会增加高达25毫克的口腔剂量。您的医生也可以选择将您送到皮下注射，从而为您教导您如何做到自己。

甲氨蝶呤适用于RA，因为它抑制了你的免疫系统，因此也是导致Ra炎症的自身免疫反应。确保你是careful around infection and during flu season- 尽可能远离病人，经常洗手。服用甲氨蝶呤时，你也应该小心，重要的是你每周只服用一次。丸看起来非常类似于许多其他片剂，这可能导致一个意外过量。

服用甲氨蝶呤时，您的医生将每六周订购血液测试以检查您的肝功能。该药物通过触发身体的细胞来释放含腺苷的物质，阻止炎症。然而，它也可以导致肝脏中的瘢痕组织，这可能很少，develop into liver disease。您的医生可能会规定叶酸，可预防瘢痕组织和其他副作用。尽管如此，对肝脏功能仍然是必不可少的。

虽然甲氨蝶呤被认为是安全的并且通常是耐受性的，但它是共同效应服用药物后，在RA社区中称为“甲基甲酸甲酸冻结”。服用剂量后一两天，您可能会恶心，头晕，并头疼。吃平淡的食物并轻松占据它通常足以应对。

如果您对GI副作用有困难时，有些步骤可以帮助减少症状。一个是分开你的剂量，早上占用一半的甲氨蝶呤平板电脑，晚上的另一半。同样，将它们带入食物将使您的胃更容易。抗恶心药物，无论是柜台还是处方，也可能有所帮助。您还可以与您的医生交换切换到可注射的甲氨蝶呤，这通常会降低额外的肠副作用。

Some people develop mouth ulcers when taking methotrexate, especially if they are on higher doses. This is caused bymucositis，粘膜的炎症可引起嘴里的疮。通过服用叶酸可以防止这些，但如果它们发生发展，用盐水溶剂漂洗n or a special mouthwash containing lidocaine can ease symptoms.

Although quite rare, methotrexate may causehair loss。这种药物是通过阻止细胞growing, which includes the cells that cause inflammation. Unfortunately, it can also affect the hair follicles in about one to three percent of people taking the medication. The effect may be more of a thinning rather than your hair falling out in chunks. As with all side effects, you have to weigh the pros and cons and make thedecision about treatment that is right for you。

As you have seen, folic acid is an important companion when taking methotrexate. Folic acid is a synthetic form of vitamin B9 and may be prescribed as 1 mg a day or 5 mg once a week. Some rheumatologists don’t prescribe folic acid until the person experiences certain side effects. One study showed that taking folic acidreduced the experience of side effects by up to 26 percent。It’s important to not take too much folic acid, as it can mask a B12 deficiency.

由于甲氨蝶呤对肝脏的潜在影响，许多风湿病学家在服用这种药物时建议饮酒饮酒。这可以变化from not at all (primarily in the United States), to only once in a blue moon (in Europe). The American College of Rheumatology recommends against drinking alcohol on this medication, but some doctors allow it very occasionally. If you have a history of alcohol abuse or have liver disease, methotrexate is generally not recommended.

Although methotrexate tends to be well tolerated by the person taking it, it is not tolerated at all by a developing fetus. This medication cancause severe birth defectsand it is essential that you not get pregnant while taking it. Doctors usually recommend double methods of birth control (for instance, the pill and a condom). You should be off methotrexate for three months before trying to conceive. If you do want to start a family, talk to your rheumatologist.

随着所有这些副作用的潜力，在服用甲氨蝶呤时不得不小心，你可能会非常问自己为什么要把它拿走。RA是一个严重的疾病，未经治疗，具有非常真实的可能性造成损害关节，内脏和身体的其他系统。Methotrexate is one of the medications that suppresses RA and therefore protects your ability to live your life to the fullest.