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Brand name: methotrexate
Generic name: amethopterin, Emthexate, Methoblastin, MTX, Rheumatrex
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Her RA had been treated with methotrexate (10 mg per week) and bucillamine (200 mg per day) for 6 years. 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. Such patients require especially careful monitoring for toxicity, and require dose reduction or, in some cases, discontinuation of methotrexate administration. MANAGEMENT: The use of methotrexate in combination with other potentially hepatotoxic agents (e. It is recommended that duration of leucovorin administration in these patients be based on determination of plasma methotrexate concentrations. 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. Taking methotrexate and alcohol together may increase the risk of liver injury. Antibodies developed in 12% of patients on adalimumab monotherapy and in 1% of patients on concurrent methotrexate.

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