Metoject

Methotrexate, the active ingredient in Metoject, is an antimetabolite (folate antagonist) presented as a subcutaneous formulation for injection use. It is employed to modify disease activity in rheumatoid arthritis, manage severe psoriasis, and treat certain cancers such as acute lymphoblastic leukemia and non‑Hodgkin lymphoma, as well as to resolve ectopic pregnancy.

GNH USA supplies Metoject as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, pharmacies and clinics worldwide.

Methotrexate acts as a folate antagonist used across several disease families, primarily inflammatory and oncologic conditions.

- Rheumatoid arthritis: reduces disease activity and joint inflammation. - Psoriasis: limits skin cell proliferation and improves lesions. - Acute lymphoblastic leukemia: interferes with malignant cell replication. - Non‑Hodgkin lymphoma: suppresses growth of lymphoma cells. - Ectopic pregnancy: terminates trophoblastic tissue to avoid surgical intervention.

Methotrexate may cause a range of adverse reactions, from mild to severe.

Common Side Effects: - Nausea or vomiting. - Fatigue or general weakness. - Oral mucosal ulceration (mouth sores). - Mild elevation of liver enzymes.

Serious or Rare Side Effects: - Severe hepatotoxicity or liver fibrosis. - Pulmonary fibrosis or interstitial pneumonitis. - Life‑threatening bone marrow suppression leading to pancytopenia. - Acute kidney injury or renal failure. - Severe cutaneous reactions such as Stevens‑Johnson syndrome. - Opportunistic infections due to immunosuppression.

Methotrexate requires careful monitoring and specific safety measures before and during therapy.

- Pregnancy avoidance: contraindicated in pregnancy (Category X) and requires effective contraception. - Renal function: assess creatinine clearance before initiation and periodically thereafter. - Hepatic monitoring: perform baseline and regular liver function tests. - Hematologic surveillance: obtain complete blood counts to detect myelosuppression. - Drug interaction review: evaluate concomitant medications for potential additive toxicity. - Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Methotrexate interacts with several medicines that can alter its safety or efficacy.

Major Interactions (Avoid): - Nonsteroidal anti‑inflammatory drugs (NSAIDs): increase risk of renal toxicity and gastrointestinal ulceration. - Trimethoprim‑sulfamethoxazole: potentiate myelosuppression. - Live vaccines: heightened risk of infection due to immunosuppression. - Pemetrexed: additive folate antagonism leading to severe toxicity.

Moderate Interactions (Monitor Closely): - Proton pump inhibitors: may affect methotrexate absorption and increase serum levels. - Phenytoin: can reduce methotrexate efficacy by enhancing hepatic metabolism. - Azathioprine: combined use may increase bone‑marrow suppression.