Brand name: methotrexate
Generic name: Emthexate, MTX, Rheumatrex, amethopterin, Methoblastin

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Leucovorin also is indicated as a rescue after high-dose methotrexate therapy in osteosarcoma and as a part of chemotherapeutic treatment programs in the management of several forms of cancer. Leucovorin may limit methotrexate action on normal cells by competing with methotrexate for the same transport processes into the cell. This indicates that NSAIDs may enhance the toxicity of methotrexate. Methotrexate elimination is reduced in patients with impaired renal function, ascites, or pleural effusions. 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. Methotrexate has been reported to cause fetal death and/or congenital anomalies. Antibodies developed in 12% of patients on adalimumab monotherapy and in 1% of patients on concurrent methotrexate. It is recommended that duration of leucovorin administration in these patients be based on determination of plasma methotrexate concentrations. Such patients require especially careful monitoring for toxicity, and require dose reduction or, in some cases, discontinuation of methotrexate administration. She had been successfully treated with infliximab 3 mg/kg every 6 to 8 weeks together with methotrexate, without side effects. He was treated for RA with infliximab (3 mg/kg) for 3 years, as well as methotrexate (20 mg/week), and corticosteroids.

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