methotrexate

ROUTE	ONSET	PEAK	DURATION
PO, IM, IV	4–7 days	7–14 days	21 days
SUBQ	unknown	unknown	unknown

Acute Lymphoblastic Leukemia

IV (Adults and Children ): 10–5,000 mg/m² followed by leucovorin rescue (for doses >500 mg/m²). Lower doses (20–30 mg/m²/wk may be used IM.
PO (Adults ): 20 mg/m² once weekly

Meningeal Leukemia

(Adults and Children ≥9 yr): 12–15 mg given at intervals of 2 or more days up to twice weekly (for treatment) and no more than once weekly (for prophylaxis).
(Children 3–<9 yr): 12 mg given at intervals of 2 or more days up to twice weekly (for treatment) and no more than once weekly (for prophylaxis).
(Children 2–<3 yr): 10 mg given at intervals of 2 or more days up to twice weekly (for treatment) and no more than once weekly (for prophylaxis).
(Children 1–<2 yr): 8 mg given at intervals of 2 or more days up to twice weekly (for treatment) and no more than once weekly (for prophylaxis).
(Children <1 yr): 6 mg given at intervals of 2 or more days up to twice weekly (for treatment) and no more than once weekly (for prophylaxis).

Non-Hodgkin's Lymphoma

IV (Adults and Children ): In combination with other chemotherapy agents: 1000 mg/m² or 3000 mg/m² over 24 hours followed by leucovorin rescue. CNS-directed therapy: 8000 mg/m² over 4 hr followed by leucovorin rescue (as monotherapy) or 3000–8000 mg/m² followed by leucovorin rescue (in combination with immunochemotherapy).
PO (Adults ): 2.5 mg 2–4 times weekly.

Osteosarcoma

IV (Adults and Children ): 12 g/m² (max = 20 g/dose) over 4 hr followed by leucovorin rescue, usually as part of a combination chemotherapeutic regimen (or ↑ dose until peak serum methotrexate level is 1 × 10^-3 M/L but not to exceed 15 g/m²); 12 courses are given starting 4 wk after surgery and repeated at scheduled intervals.

Breast Cancer

IV (Adults ): 40 mg/m² on days 1 and 8 (with other agents; many regimens are used).

Squamous Cell Carcinoma of Head and Neck

IV (Adults ): 40–60 mg/m² once weekly.

Gestational Trophoblastic Neoplasia

IV IM (Adults ): Low-risk gestational trophoblastic neoplasia: 30–200 mg/m².
IV (Adults ): High-risk gestational trophoblastic neoplasia: 300 mg/m² over 12 hr (with other agents).

Mycosis Fungoides

PO (Adults ): Monotherapy: 25–75 mg once weekly; As part of combination regimen: 10 mg/m² twice weekly.
IM (Adults ): Early stage: 5–50 mg once weekly; If poor response to weekly therapy: 15–37.5 mg twice weekly.

Rheumatoid Arthritis

PO IM SC (Adults ): 7.5 mg once weekly (not to exceed 20 mg/wk); when optimal clinical response is obtained, dose should be ↓. Otrexup may be used when dose is 10–20 mg/wk.

Polyarticular Juvenile Idiopathic Arthritis

PO IM SC (Children ): 10 mg/m² once weekly initially, may be ↑ up to 20–30 mg/m²; however, response may be better if doses >20 mg/m² are given IM or SUBQ; Otrexup may be used when dose is 10–25 mg/wk.

Psoriasis

Therapy may be preceded by a 5–10-mg test dose
PO IM SC IV (Adults ): 10–25 mg once weekly (not to exceed 25 mg/wk); when optimal clinical response is obtained, dose should be ↓. Otrexup may be used when dose is 10–25 mg/wk.

Availability ⬆ ⬇

(Generic available)

Tablets: 2.5 mg; 5 mg; 7.5 mg; 10 mg; 15 mg
Oral solution (Jylamvo) orange flavor: 2 mg/mL
Oral solution (Xatmep) orange flavor: 2.5 mg/mL
Solution for SUBQ injection (Otrexup): 10 mg/0.4 mL; 12.5 mg/0.4 mL; 15 mg/0.4 mL; 17.5 mg/0.4 mL; 20 mg/0.4 mL; 22.5 mg/0.4 mL; 25 mg/0.4 mL
Solution for SUBQ injection (Rasuvo): 7.5 mg/0.15 mL; 10 mg/0.2 mL; 12.5 mg/0.25 mL; 15 mg/0.3 mL; 17.5 mg/0.35 mL; 20 mg/0.4 mL; 22.5 mg/0.45 mL; 25 mg/0.5 mL; 30 mg/0.6 mL
Powder for injection: 1 g/vial
Solution for injection: 25 mg/mL
Solution for injection (preservative free): 25 mg/mL

Assessment ⬆ ⬇

Monitor vital signs periodically during administration. Report significant changes.
- Monitor for abdominal pain, diarrhea, or stomatitis; therapy may need to be discontinued.
- Monitor for bone marrow depression. Assess for bleeding (bleeding gums, bruising, petechiae, guaiac stools, urine, and emesis) and avoid IM injections and taking rectal temperatures if platelet count is low. Apply pressure to venipuncture sites for 10 min. Assess for signs of infection during neutropenia. Anemia may occur. Monitor for increased fatigue, dyspnea, and orthostatic hypotension.
- Monitor intake and output ratios and daily weights. Report significant changes in totals.
- Monitor for symptoms of interstitial pneumonitis, which may manifest early as a dry, nonproductive cough.
- Monitor for symptoms of gout (increased uric acid, joint pain, edema). Encourage patient to drink at least 2 L of fluid each day. Allopurinol and alkalinization of urine may be used to decrease uric acid levels.
- Assess nutritional status. Administering an antiemetic prior to and periodically during therapy and adjusting diet as tolerated may help maintain fluid and electrolyte balance and nutritional status.
Assess for rash periodically during therapy. May cause Stevens-Johnson syndrome. Discontinue therapy if severe or if accompanied with fever, general malaise, fatigue, muscle or joint aches, blisters, oral lesions, conjunctivitis, hepatitis, and/or eosinophilia.
Assess for development of nuchal rigidity, headache, fever, confusion, drowsiness, dizziness, weakness, or seizures.
Rheumatoid Arthritis: Assess patient for pain and range of motion prior to and periodically during therapy.
Psoriasis: Assess skin lesions prior to and periodically during therapy.

Lab Test Considerations:

Verify negative pregnancy test prior to starting therapy.Monitor CBC and differential prior to and at least monthly during therapy and at least daily for high-dose regimens. The nadir of leukopenia and thrombocytopenia occurs in 7–14 days. Leukocyte and thrombocyte counts usually recover 7 days after the nadirs. Discontinue methotrexate immediately for any sudden drop in values.
- Monitor renal (BUN and serum creatinine) and hepatic function (AST, ALT, bilirubin, and LDH) prior to and every 1–2 mo during therapy. Urine pH should be monitored prior to high-dose methotrexate therapy and every 6 hr during leucovorin rescue. Urine pH should be kept above 7.0 from before 1st dose through therapy to prevent renal damage.
- May cause ↑ serum uric acid concentrations, especially during initial treatment of leukemia and lymphoma.

Toxicity and Overdose:

Monitor serum methotrexate levels at least daily during high-dose therapy and adjust hydration and leucovorin dosing as needed. This monitoring is essential to plan correct leucovorin dose and determine duration of rescue therapy.
- With high-dose therapy (doses of ≥500 mg/m²), patient must receive leucovorin rescue within 24–48 hr to prevent fatal toxicity. May be considered for intermediate doses of 100 mg/m² to <500 mg/m². Administer IV fluids starting before 1st dose and continuing through therapy to maintain adequate hydration and urine output. Administer glucarpidase in patients who have toxic plasma methotrexate concentrations (>1 micromole per liter) and delayed methotrexate clearance due to impaired renal function. Glucarpidase may be used for patients with impaired renal function. If glucarpidase is used, do not administer leucovorin within 2 hrs before or after glucarpidase because leucovorin is a substrate for glucarpidase. In cases of massive overdose, hydration and urinary alkalinization with sodium bicarbonate are required to prevent renal tubule damage. Leucovorin and levoleucovorin are indicated to diminish the toxicity and counteract the effect of inadvertently administered overdoses of methotrexate. Monitor fluid and electrolyte status; patients must be well hydrated. Intermittent hemodialysis using a high-flux dialyzer may be used for clearance until levels are <0.05 micromolar. Methotrexate should be delayed until recovery if WBC <1500/mcL, neutrophil count <200/mcL, platelet count <75,000/mcL, serum bilirubin level >1.2 mg/dL, AST level >450 IU/L, mucositis is present, until evidence of healing, persistent pleural effusion is present, should be drained dry prior to infusion. Adequate renal function is required. Serum creatinine must be normal, CCr must be >60 mL/min, before initiation of therapy. Serum creatinine must be measured before each course of therapy. If ↑ by ≥50% of a prior value, CCr must be >60 mL/min, even if serum creatinine is within normal range.

Implementation ⬆ ⬇

Fatalities have occurred with chemotherapeutic agents. Before administering, clarify all ambiguous orders; double-check single, daily, and course-of-therapy dose limits; have second practitioner independently double-check original order, calculations, and infusion pump settings. Methotrexate for nononcologic use is given at a much lower dose and frequency—often just once a wk. Do not confuse nononcologic dosing regimens with dosing regimens for cancer patients. Do not confuse methotrexate with metolazone or MTX Patch (lidocaine/menthol). Do not confuse Trexall with Paxil.
Administer IV fluids starting before 1st dose and continuing through therapy to maintain adequate hydration and urine output.
Solutions for injection should be prepared in a biologic cabinet. Wear gloves, gown, and mask while handling medication. Discard equipment in specially designated containers.
PO: Use only the copackaged syringe to measure Jylamvo; a teaspoon is not an accurate measuring device. Solution is clear yellow; do not administer solutions that are discolored, cloudy, or contain particulate matter.
Otrexup and Rasuvo are not indicated for treatment of neoplastic diseases. Not for patients requiring oral, IM, IV, intra-arterial, or IT dosing, doses <10 mg/wk, doses >25 mg/wk, high-dose regimens, or dose adjustments of less than 5 mg increments.
SC: Otrexup and Rasuvo are single-dose auto-injectors. Inject once weekly in abdomen or upper thigh. Avoid areas where skin is tender, bruised, red, scaly, hard, or has scars or stretch marks. Solution is clear and yellow; do not inject solutions that are discolored or contain particulate matter.
Reconstitute preservative-free methotrexate with preservative-free 0.9% NaCl, Elliot’s B solution, or patient’s CSF to a concentration not greater than 2 mg/mL. May be administered via lumbar puncture or Ommaya reservoir. To prevent bacterial contamination, use immediately.

IV Administration:

Reconstitution: Reconstitute each vial with 25 mL of 0.9% NaCl. Use sterile preservative-free diluents for high-dose regimens, neonates, low-birth weight infants, and intrathecal use to prevent complications from large amounts of benzyl alcohol. Solution is clear yellow; do not use preparations that are cloudy, discolored or that contain a precipitate. Reconstitute immediately before use. Discard unused portion.Concentration: 25 mg/mL for IV push and intermittent/continuous infusions.
Rate: Administer at a rate of 10 mg/min into Y-site of a free-flowing IV.
Intermittent/Continuous Infusion: Diluent: Doses >100–300 mg/m2 may also be diluted in D5W, D5/0.9% NaCl, or 0.9% NaCl and infused as intermittent or continuous infusion.
Rate: Administration rates of 4–20 mg/hr have been used.

Patient/Family Teaching ⬆ ⬇

Instruct patient to take medication as directed. If a dose is missed, it should be omitted. Consult health care professional if vomiting occurs shortly after a dose is taken. Advise patients taking PO or SUBQ therapy to read Patient Information before starting therapy and with each Rx refill in case of changes.
Instruct patient to notify health care professional promptly if rash, fever; chills; cough; hoarseness; sore throat; signs of infection; lower back or side pain; painful or difficult urination; bleeding gums; bruising; petechiae; blood in stools, urine, or emesis; increased fatigue; dyspnea; or orthostatic hypotension occurs. Caution patient to avoid crowds and persons with known infections. Instruct patient to use soft toothbrush and electric razor and to avoid falls. Caution patient not to drink alcoholic beverages or take medication containing aspirin or other NSAIDs; may precipitate gastric bleeding.
Instruct patient to inspect oral mucosa for erythema and ulceration. If ulceration occurs, advise patient to use sponge brush and to rinse mouth with water after eating and drinking. Topical therapy may be used if mouth pain interferes with eating. Stomatitis pain may require treatment with opioid analgesics.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
Discuss the possibility of hair loss with patient. Explore methods of coping.
Instruct patient not to receive any vaccinations without advice of health care professional.
Caution patient to use sunscreen and protective clothing to prevent photosensitivity reactions.
Rep: May cause fetal harm. Advise females of reproductive potential to use effective contraception during and for 6 mo after last dose and avoid breastfeeding during and for 1 wk after last dose of therapy. Advise males with female partners of reproductive potential to use effective contraception during and for 3 mo after therapy. Advise patient to notify health care professional if pregnancy is planned or suspected. May impair fertility in both men and women.
Emphasize the need for periodic lab tests to monitor for side effects.
SC: Instruct patient on correct technique for injection and care and disposal of equipment.

Evaluation/Desired Outcomes ⬆ ⬇

Improvement of hematopoietic values in leukemia.
- Decrease in symptoms of meningeal involvement in leukemia.
Decrease in size and spread of non-Hodgkin’s lymphomas and other solid cancers.
Resolution of skin lesions in severe psoriasis.
Decreased joint pain and swelling.
- Improved mobility in patients with rheumatoid arthritis.
Regression of lesions in mycosis fungoides.

US Brand Names ⬆ ⬇

Jylamvo, Otrexup, Rasuvo, ~~Rheumatrex,~~ Trexall, Xatmep

Canadian Brand Names ⬆ ⬇

Code ⬆

NDC Code

0054- West-Ward Pharmaceuticals Corp.
- 0054-4550- Methotrexate Sodium
  - 0054-4550-15- 36 TABLET in 1 BOTTLE, PLASTIC (0054-4550-15)

0054- West-Ward Pharmaceuticals Corp.
- 0054-4550- Methotrexate Sodium
  - 0054-4550-25- 100 TABLET in 1 BOTTLE, PLASTIC (0054-4550-25)

0054- West-Ward Pharmaceuticals Corp.
- 0054-8550- Methotrexate Sodium
  - 0054-8550-25- 10 BLISTER PACK in 1 CARTON (0054-8550-25) > 10 TABLET in 1 BLISTER PACK

0143- Hikma Pharmaceuticals USA Inc.
- 0143-9367- Methotrexate
  - 0143-9367-01- 1 VIAL in 1 BOX (0143-9367-01) > 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL

0143- West-Ward Pharmaceuticals Corp
- 0143-9516- Methotrexate
  - 0143-9516-01- 1 VIAL in 1 BOX (0143-9516-01) > 10 mL in 1 VIAL

0143- West-Ward Pharmaceuticals Corp
- 0143-9517- Methotrexate
  - 0143-9517-01- 1 VIAL in 1 BOX (0143-9517-01) > 8 mL in 1 VIAL

0143- West-Ward Pharmaceuticals Corp
- 0143-9518- Methotrexate
  - 0143-9518-01- 1 VIAL in 1 BOX (0143-9518-01) > 4 mL in 1 VIAL

0143- West-Ward Pharmaceuticals Corp
- 0143-9519- Methotrexate
  - 0143-9519-10- 10 VIAL in 1 CARTON (0143-9519-10) > 2 mL in 1 VIAL

0143- Hikma Pharmaceuticals USA Inc.
- 0143-9830- Methotrexate
  - 0143-9830-01- 1 VIAL in 1 BOX (0143-9830-01) > 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL

0378- Mylan Pharmaceuticals Inc.
- 0378-0014- Methotrexate
  - 0378-0014-01- 100 TABLET in 1 BOTTLE, PLASTIC (0378-0014-01)

0555- Teva Pharmaceuticals USA, Inc.
- 0555-0572- Methotrexate
  - 0555-0572-02- 100 TABLET in 1 BOTTLE (0555-0572-02)

0555- Teva Pharmaceuticals USA, Inc.
- 0555-0572- Methotrexate
  - 0555-0572-35- 36 TABLET in 1 BOTTLE (0555-0572-35)

0703- Teva Parenteral Medicines, Inc.
- 0703-3671- Methotrexate
  - 0703-3671-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (0703-3671-01) > 2 mL in 1 VIAL, SINGLE-DOSE

0703- Teva Parenteral Medicines, Inc.
- 0703-3675- Methotrexate
  - 0703-3675-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (0703-3675-01) > 10 mL in 1 VIAL, SINGLE-DOSE

0703- Teva Parenteral Medicines, Inc.
- 0703-3678- Methotrexate
  - 0703-3678-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (0703-3678-01) > 40 mL in 1 VIAL, SINGLE-DOSE

0703- Teva Parenteral Medicines, Inc.
- 0703-3678- Methotrexate
  - 0703-3678-81- 1 VIAL, SINGLE-DOSE in 1 CARTON (0703-3678-81) > 40 mL in 1 VIAL, SINGLE-DOSE

16729- Accord Healthcare, Inc.
- 16729-277- Methotrexate
  - 16729-277-03- 1 VIAL in 1 CARTON (16729-277-03) > 10 mL in 1 VIAL

16729- Accord Healthcare, Inc.
- 16729-277- Methotrexate
  - 16729-277-30- 1 VIAL in 1 CARTON (16729-277-30) > 2 mL in 1 VIAL

16729- Accord Healthcare, Inc.
- 16729-277- Methotrexate
  - 16729-277-35- 1 VIAL in 1 CARTON (16729-277-35) > 40 mL in 1 VIAL

42291- AvKARE, Inc.
- 42291-594- Methotrexate
  - 42291-594-01- 100 TABLET in 1 BOTTLE (42291-594-01)

43063- PD-Rx Pharmaceuticals, Inc.
- 43063-439- Methotrexate
  - 43063-439-30- 30 TABLET in 1 BOTTLE, PLASTIC (43063-439-30)

47335- Sun Pharmaceutical Industries, Inc.
- 47335-235- Methotrexate
  - 47335-235-83- 100 TABLET in 1 BOTTLE (47335-235-83)

47335- Sun Pharmaceutical Industries, Inc.
- 47335-235- Methotrexate
  - 47335-235-96- 36 TABLET in 1 BOTTLE (47335-235-96)

50090- A-S Medication Solutions
- 50090-0294- METHOTREXATE
  - 50090-0294-9- 36 TABLET in 1 BOTTLE (50090-0294-9)

50090- A-S Medication Solutions
- 50090-2345- Methotrexate
  - 50090-2345-9- 36 TABLET in 1 BOTTLE (50090-2345-9)

50090- A-S Medication Solutions
- 50090-3418- Methotrexate
  - 50090-3418-2- 100 TABLET in 1 BOTTLE (50090-3418-2)

50090- A-S Medication Solutions
- 50090-3418- Methotrexate
  - 50090-3418-9- 36 TABLET in 1 BOTTLE (50090-3418-9)

51079- Mylan Institutional Inc.
- 51079-670- Methotrexate
  - 51079-670-05- 20 BLISTER PACK in 1 CARTON (51079-670-05) > 1 TABLET in 1 BLISTER PACK (51079-670-01)

51285- Teva Women's Health, Inc.
- 51285-366- Trexall
  - 51285-366-01- 30 TABLET, FILM COATED in 1 BOTTLE (51285-366-01)

51285- Teva Women's Health, Inc.
- 51285-367- Trexall
  - 51285-367-01- 30 TABLET, FILM COATED in 1 BOTTLE (51285-367-01)

51285- Teva Women's Health, Inc.
- 51285-368- Trexall
  - 51285-368-01- 30 TABLET, FILM COATED in 1 BOTTLE (51285-368-01)

51285- Teva Women's Health, Inc.
- 51285-369- Trexall
  - 51285-369-01- 30 TABLET, FILM COATED in 1 BOTTLE (51285-369-01)

51407- Golden State Medical Supply Inc.
- 51407-121- Methotrexate
  - 51407-121-01- 100 TABLET in 1 BOTTLE, PLASTIC (51407-121-01)

52652- Silvergate Pharmaceuticals, Inc.
- 52652-2001- Xatmep
  - 52652-2001-1- 120 mL in 1 BOTTLE (52652-2001-1)

52652- Silvergate Pharmaceuticals, Inc.
- 52652-2001- Xatmep
  - 52652-2001-6- 60 mL in 1 BOTTLE (52652-2001-6)

54436- Antares Pharma, Inc.
- 54436-010- Otrexup
  - 54436-010-01- 1 SYRINGE in 1 CARTON (54436-010-01) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-010- Otrexup
  - 54436-010-03- 1 SYRINGE in 1 CARTON (54436-010-03) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-010- Otrexup
  - 54436-010-04- 4 SYRINGE in 1 CARTON (54436-010-04) > .4 mL in 1 SYRINGE (54436-010-02)

54436- Antares Pharma, Inc.
- 54436-012- Otrexup
  - 54436-012-01- 1 SYRINGE in 1 CARTON (54436-012-01) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-012- Otrexup
  - 54436-012-03- 1 SYRINGE in 1 CARTON (54436-012-03) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-012- Otrexup
  - 54436-012-04- 4 SYRINGE in 1 CARTON (54436-012-04) > .4 mL in 1 SYRINGE (54436-012-02)

54436- Antares Pharma, Inc.
- 54436-015- Otrexup
  - 54436-015-01- 1 SYRINGE in 1 CARTON (54436-015-01) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-015- Otrexup
  - 54436-015-03- 1 SYRINGE in 1 CARTON (54436-015-03) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-015- Otrexup
  - 54436-015-04- 4 SYRINGE in 1 CARTON (54436-015-04) > .4 mL in 1 SYRINGE (54436-015-02)

54436- Antares Pharma, Inc.
- 54436-017- Otrexup
  - 54436-017-01- 1 SYRINGE in 1 CARTON (54436-017-01) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-017- Otrexup
  - 54436-017-03- 1 SYRINGE in 1 CARTON (54436-017-03) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-017- Otrexup
  - 54436-017-04- 4 SYRINGE in 1 CARTON (54436-017-04) > .4 mL in 1 SYRINGE (54436-017-02)

54436- Antares Pharma, Inc.
- 54436-020- Otrexup
  - 54436-020-01- 1 SYRINGE in 1 CARTON (54436-020-01) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-020- Otrexup
  - 54436-020-03- 1 SYRINGE in 1 CARTON (54436-020-03) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-020- Otrexup
  - 54436-020-04- 4 SYRINGE in 1 CARTON (54436-020-04) > .4 mL in 1 SYRINGE (54436-020-02)

54436- Antares Pharma, Inc.
- 54436-022- Otrexup
  - 54436-022-01- 1 SYRINGE in 1 CARTON (54436-022-01) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-022- Otrexup
  - 54436-022-03- 1 SYRINGE in 1 CARTON (54436-022-03) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-022- Otrexup
  - 54436-022-04- 4 SYRINGE in 1 CARTON (54436-022-04) > .4 mL in 1 SYRINGE (54436-022-02)

54436- Antares Pharma, Inc.
- 54436-025- Otrexup
  - 54436-025-01- 1 SYRINGE in 1 CARTON (54436-025-01) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-025- Otrexup
  - 54436-025-03- 1 SYRINGE in 1 CARTON (54436-025-03) > .4 mL in 1 SYRINGE

54436- Antares Pharma, Inc.
- 54436-025- Otrexup
  - 54436-025-04- 4 SYRINGE in 1 CARTON (54436-025-04) > .4 mL in 1 SYRINGE (54436-025-02)

59137- Medac Pharma, Inc
- 59137-505- Rasuvo
  - 59137-505-01- 1 PACKAGE in 1 CARTON (59137-505-01) > .15 mL in 1 PACKAGE (59137-505-00)

59137- Medac Pharma, Inc
- 59137-505- Rasuvo
  - 59137-505-04- 4 PACKAGE in 1 CARTON (59137-505-04) > .15 mL in 1 PACKAGE (59137-505-00)

59137- Medac Pharma, Inc
- 59137-510- Rasuvo
  - 59137-510-01- 1 PACKAGE in 1 CARTON (59137-510-01) > .2 mL in 1 PACKAGE (59137-510-00)

59137- Medac Pharma, Inc
- 59137-510- Rasuvo
  - 59137-510-04- 4 PACKAGE in 1 CARTON (59137-510-04) > .2 mL in 1 PACKAGE (59137-510-00)

59137- Medac Pharma, Inc
- 59137-515- Rasuvo
  - 59137-515-01- 1 PACKAGE in 1 CARTON (59137-515-01) > .25 mL in 1 PACKAGE (59137-515-00)

59137- Medac Pharma, Inc
- 59137-515- Rasuvo
  - 59137-515-04- 4 PACKAGE in 1 CARTON (59137-515-04) > .25 mL in 1 PACKAGE (59137-515-00)

59137- Medac Pharma, Inc
- 59137-520- Rasuvo
  - 59137-520-01- 1 PACKAGE in 1 CARTON (59137-520-01) > .3 mL in 1 PACKAGE (59137-520-00)

59137- Medac Pharma, Inc
- 59137-520- Rasuvo
  - 59137-520-04- 4 PACKAGE in 1 CARTON (59137-520-04) > .3 mL in 1 PACKAGE (59137-520-00)

59137- Medac Pharma, Inc
- 59137-525- Rasuvo
  - 59137-525-01- 1 PACKAGE in 1 CARTON (59137-525-01) > .35 mL in 1 PACKAGE (59137-525-00)

59137- Medac Pharma, Inc
- 59137-525- Rasuvo
  - 59137-525-04- 4 PACKAGE in 1 CARTON (59137-525-04) > .35 mL in 1 PACKAGE (59137-525-00)

59137- Medac Pharma, Inc
- 59137-530- Rasuvo
  - 59137-530-01- 1 PACKAGE in 1 CARTON (59137-530-01) > .4 mL in 1 PACKAGE (59137-530-00)

59137- Medac Pharma, Inc
- 59137-530- Rasuvo
  - 59137-530-04- 4 PACKAGE in 1 CARTON (59137-530-04) > .4 mL in 1 PACKAGE (59137-530-00)

59137- Medac Pharma, Inc
- 59137-535- Rasuvo
  - 59137-535-01- 1 PACKAGE in 1 CARTON (59137-535-01) > .45 mL in 1 PACKAGE (59137-535-00)

59137- Medac Pharma, Inc
- 59137-535- Rasuvo
  - 59137-535-04- 4 PACKAGE in 1 CARTON (59137-535-04) > .45 mL in 1 PACKAGE (59137-535-00)

59137- Medac Pharma, Inc
- 59137-540- Rasuvo
  - 59137-540-01- 1 PACKAGE in 1 CARTON (59137-540-01) > .5 mL in 1 PACKAGE (59137-540-00)

59137- Medac Pharma, Inc
- 59137-540- Rasuvo
  - 59137-540-04- 4 PACKAGE in 1 CARTON (59137-540-04) > .5 mL in 1 PACKAGE (59137-540-00)

59137- Medac Pharma, Inc
- 59137-550- Rasuvo
  - 59137-550-01- 1 PACKAGE in 1 CARTON (59137-550-01) > .6 mL in 1 PACKAGE (59137-550-00)

59137- Medac Pharma, Inc
- 59137-550- Rasuvo
  - 59137-550-04- 4 PACKAGE in 1 CARTON (59137-550-04) > .6 mL in 1 PACKAGE (59137-550-00)

61703- Hospira, Inc.
- 61703-350- Methotrexate
  - 61703-350-10- 5 VIAL in 1 CARTON (61703-350-10) > 2 mL in 1 VIAL (61703-350-09)

61703- Hospira, Inc.
- 61703-350- Methotrexate
  - 61703-350-38- 5 VIAL in 1 CARTON (61703-350-38) > 2 mL in 1 VIAL (61703-350-37)

61703- Hospira, Inc.
- 61703-408- Methotrexate
  - 61703-408-41- 1 VIAL in 1 CARTON (61703-408-41) > 40 mL in 1 VIAL

63323- Fresenius Kabi USA, LLC
- 63323-122- Methotrexate
  - 63323-122-50- 1 VIAL in 1 CARTON (63323-122-50) > 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL

63323- Fresenius Kabi USA, LLC
- 63323-123- Methotrexate
  - 63323-123-10- 1 VIAL in 1 CARTON (63323-123-10) > 10 mL in 1 VIAL

67253- Par Pharmaceutical
- 67253-320- METHOTREXATE
  - 67253-320-10- 100 TABLET in 1 BOTTLE (67253-320-10)

67253- Par Pharmaceutical
- 67253-320- METHOTREXATE
  - 67253-320-36- 36 TABLET in 1 BOTTLE (67253-320-36)

67457- Mylan Institutional LLC
- 67457-466- Methotrexate
  - 67457-466-10- 1 VIAL in 1 CARTON (67457-466-10) > 10 mL in 1 VIAL

67457- Mylan Institutional LLC
- 67457-480- Methotrexate
  - 67457-480-40- 1 VIAL in 1 CARTON (67457-480-40) > 40 mL in 1 VIAL

68382- Zydus Pharmaceuticals (USA) Inc.
- 68382-775- Methotrexate
  - 68382-775-01- 100 TABLET in 1 BOTTLE (68382-775-01)

68382- Zydus Pharmaceuticals (USA) Inc.
- 68382-775- Methotrexate
  - 68382-775-05- 500 TABLET in 1 BOTTLE (68382-775-05)

68382- Zydus Pharmaceuticals (USA) Inc.
- 68382-775- Methotrexate
  - 68382-775-10- 1000 TABLET in 1 BOTTLE (68382-775-10)

68382- Zydus Pharmaceuticals (USA) Inc.
- 68382-775- Methotrexate
  - 68382-775-16- 90 TABLET in 1 BOTTLE (68382-775-16)

68382- Zydus Pharmaceuticals (USA) Inc.
- 68382-775- Methotrexate
  - 68382-775-60- 36 TABLET in 1 BOTTLE (68382-775-60)

68382- Zydus Pharmaceuticals (USA) Inc.
- 68382-775- Methotrexate
  - 68382-775-77- 100 BLISTER PACK in 1 CARTON (68382-775-77) > 1 TABLET in 1 BLISTER PACK

69238- Amneal Pharmaceuticals NY LLC
- 69238-1423- Methotrexate
  - 69238-1423-1- 100 TABLET in 1 BOTTLE (69238-1423-1)

69238- Amneal Pharmaceuticals NY LLC
- 69238-1423- Methotrexate
  - 69238-1423-6- 36 TABLET in 1 BOTTLE (69238-1423-6)

70518- REMEDYREPACK INC.
- 70518-0223- METHOTREXATE
  - 70518-0223-0- 30 TABLET in 1 BLISTER PACK (70518-0223-0)

70518- REMEDYREPACK INC.
- 70518-0223- METHOTREXATE
  - 70518-0223-1- 20 TABLET in 1 BOTTLE, PLASTIC (70518-0223-1)

70518- REMEDYREPACK INC.
- 70518-0223- METHOTREXATE
  - 70518-0223-2- 12 TABLET in 1 BOTTLE, PLASTIC (70518-0223-2)

70518- REMEDYREPACK INC.
- 70518-1251- Methotrexate
  - 70518-1251-0- 30 TABLET in 1 BLISTER PACK (70518-1251-0)

70518- REMEDYREPACK INC.
- 70518-1398- Methotrexate
  - 70518-1398-0- 30 TABLET in 1 BLISTER PACK (70518-1398-0)

70518- REMEDYREPACK INC.
- 70518-1398- Methotrexate
  - 70518-1398-1- 20 TABLET in 1 BOTTLE, PLASTIC (70518-1398-1)

70518- REMEDYREPACK INC.
- 70518-1398- Methotrexate
  - 70518-1398-2- 12 TABLET in 1 BOTTLE, PLASTIC (70518-1398-2)

70518- REMEDYREPACK INC.
- 70518-1398- Methotrexate
  - 70518-1398-3- 30 TABLET in 1 BOTTLE, PLASTIC (70518-1398-3)

70771- Cadila Healthcare Limited
- 70771-1058- Methotrexate
  - 70771-1058-0- 1000 TABLET in 1 BOTTLE (70771-1058-0)

70771- Cadila Healthcare Limited
- 70771-1058- Methotrexate
  - 70771-1058-1- 100 TABLET in 1 BOTTLE (70771-1058-1)

70771- Cadila Healthcare Limited
- 70771-1058- Methotrexate
  - 70771-1058-3- 36 TABLET in 1 BOTTLE (70771-1058-3)

70771- Cadila Healthcare Limited
- 70771-1058- Methotrexate
  - 70771-1058-5- 500 TABLET in 1 BOTTLE (70771-1058-5)

70771- Cadila Healthcare Limited
- 70771-1058- Methotrexate
  - 70771-1058-7- 100 BLISTER PACK in 1 CARTON (70771-1058-7) > 1 TABLET in 1 BLISTER PACK (70771-1058-2)

70771- Cadila Healthcare Limited
- 70771-1058- Methotrexate
  - 70771-1058-9- 90 TABLET in 1 BOTTLE (70771-1058-9)

71335- Bryant Ranch Prepack
- 71335-0782- Methotrexate
  - 71335-0782-1- 30 TABLET in 1 BOTTLE (71335-0782-1)

71335- Bryant Ranch Prepack
- 71335-0782- Methotrexate
  - 71335-0782-2- 12 TABLET in 1 BOTTLE (71335-0782-2)

71335- Bryant Ranch Prepack
- 71335-0782- Methotrexate
  - 71335-0782-3- 20 TABLET in 1 BOTTLE (71335-0782-3)

71335- Bryant Ranch Prepack
- 71335-0782- Methotrexate
  - 71335-0782-4- 100 TABLET in 1 BOTTLE (71335-0782-4)

71335- Bryant Ranch Prepack
- 71335-0782- Methotrexate
  - 71335-0782-5- 36 TABLET in 1 BOTTLE (71335-0782-5)

71335- Bryant Ranch Prepack
- 71335-0782- Methotrexate
  - 71335-0782-6- 24 TABLET in 1 BOTTLE (71335-0782-6)

71335- Bryant Ranch Prepack
- 71335-0782- Methotrexate
  - 71335-0782-7- 90 TABLET in 1 BOTTLE (71335-0782-7)

71335- Bryant Ranch Prepack
- 71335-0782- Methotrexate
  - 71335-0782-8- 4 TABLET in 1 BOTTLE (71335-0782-8)

71335- Bryant Ranch Prepack
- 71335-1118- Methotrexate
  - 71335-1118-1- 30 TABLET in 1 BOTTLE (71335-1118-1)

71335- Bryant Ranch Prepack
- 71335-1118- Methotrexate
  - 71335-1118-2- 12 TABLET in 1 BOTTLE (71335-1118-2)

71335- Bryant Ranch Prepack
- 71335-1118- Methotrexate
  - 71335-1118-3- 20 TABLET in 1 BOTTLE (71335-1118-3)

71335- Bryant Ranch Prepack
- 71335-1118- Methotrexate
  - 71335-1118-4- 100 TABLET in 1 BOTTLE (71335-1118-4)

71335- Bryant Ranch Prepack
- 71335-1118- Methotrexate
  - 71335-1118-5- 36 TABLET in 1 BOTTLE (71335-1118-5)

71335- Bryant Ranch Prepack
- 71335-1118- Methotrexate
  - 71335-1118-6- 24 TABLET in 1 BOTTLE (71335-1118-6)

71335- Bryant Ranch Prepack
- 71335-1118- Methotrexate
  - 71335-1118-7- 90 TABLET in 1 BOTTLE (71335-1118-7)

71335- Bryant Ranch Prepack
- 71335-1118- Methotrexate
  - 71335-1118-8- 4 TABLET in 1 BOTTLE (71335-1118-8)

section name header

Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Route/Dosage ⬆ ⬇