What is Methotrexate?
Methotrexate is a medication widely used in pediatrics to treat various conditions including juvenile idiopathic arthritis (JIA), certain types of cancer, and autoimmune diseases. It acts as a disease-modifying antirheumatic drug (DMARD) and an immunosuppressant.
How Does Methotrexate Work?
Methotrexate works by inhibiting the enzyme dihydrofolate reductase, which is necessary for the synthesis of DNA, RNA, and proteins. This mechanism helps in reducing the proliferation of cells, making it effective in conditions involving rapid cell growth and autoimmune activity.
What Are the Administration Methods?
Methotrexate can be administered orally in tablet form or via injection, either subcutaneously or intramuscularly. The choice of administration depends on the child's specific condition and the physician's recommendation.
Gastrointestinal distress (nausea, vomiting, diarrhea)
Fatigue
Stomatitis (mouth sores)
Elevated liver enzymes
Hair loss
It's crucial to monitor liver function and blood cell counts regularly while on methotrexate.
How is Dosage Determined?
The dosage of methotrexate is usually determined based on the child's body surface area (BSA) or weight and the specific condition being treated. Pediatricians often start with a low dose and gradually increase it while monitoring for efficacy and adverse effects.
Avoid live vaccines while on methotrexate.
Ensure regular blood tests to monitor liver function and blood counts.
Avoid alcohol to reduce liver toxicity.
Be cautious of infection risks due to immunosuppression.
Can Methotrexate Be Used Long-Term?
Methotrexate can be used long-term in children, especially for chronic conditions like JIA. However, long-term use requires diligent monitoring for potential adverse effects, including liver damage, lung disease, and bone marrow suppression.
The choice of alternative treatment depends on the specific condition and the child's response to methotrexate.
Conclusion
Methotrexate is a versatile and commonly used medication in pediatrics for various conditions including autoimmune diseases and certain cancers. While effective, it requires careful monitoring and adherence to safety guidelines to minimize potential side effects. Always consult a pediatrician for personalized medical advice and before making any changes to a child's treatment plan.
