Noltrexate
✅ Rheumatoid arthritis relief
✅ Psoriasis management
✅ Cancer chemotherapy support
✅ Autoimmune disorder treatment
✅ Anti-inflammatory properties
Noltrexate contains Methotrexate.
✓ Orvosi ellenőrzés Morgan Ellis — Gyógyszerkutató · 8 év tapasztalat · Utolsó felülvizsgálat: 2026 május
⚡ Quick Answer — What is Noltrexate?
Noltrexate egy tabletta formájú gyógyszer a Cipla gyártásában, mely methotrexate 2.5 mg — an antimetabolite (dihydrofolate reductase inhibitor) used for maintenance therapy of acute lymphoblastic leukaemia (ALL), some lymphomas, severe rheumatoid arthritis, severe psoriasis, and other immune-mediated disease. Oncology maintenance dose: typically 15–30 mg/m² per WEEK (NOT daily) — weekly dosing is the most critical safety point. Daily dosing of methotrexate by mistake is one of the most common preventable serious medication errors and can be fatal. Kötelező: folic acid 5 mg weekly on a different day; baseline + ongoing FBC, LFTs, U&E, CXR. Absolute contraindication in pregnancy and breastfeeding (potent teratogen).
📦 Minden rendelést fedez a Újraküldési Garancia — ha a csomagod nem érkezik meg 20 munkanapon belül, újraküldjük.
What Is Noltrexate?
Noltrexate is an oral tablet from Cipla containing methotrexate 2.5 mg. Methotrexate is a folate antagonist (dihydrofolate reductase inhibitor) used at low doses for maintenance therapy of acute lymphoblastic leukaemia (ALL), several lymphomas, certain solid tumours, and at similar low doses for severe rheumatoid arthritis, psoriasis, Crohn's disease and other immune-mediated conditions.
Felhasználás és indikációk
- Maintenance phase of acute lymphoblastic leukaemia (oral methotrexate weekly with mercaptopurine daily)
- Trophoblastic disease (gestational choriocarcinoma) — specialist oncology
- Cutaneous T-cell lymphoma, mycosis fungoides
- Severe rheumatoid arthritis — first-line DMARD
- Severe psoriasis, psoriatic arthritis
- Severe Crohn's disease maintenance
- Several other immune-mediated conditions: ANCA vasculitis, dermatomyositis, juvenile idiopathic arthritis
Dosage and How to Take — CRITICAL
Standard oncology maintenance dose: 15–30 mg/m² per WEEK (typically 20–25 mg/week for an adult). Standard rheumatology / dermatology dose: 7.5–25 mg per week.
- WEEKLY DOSING ONLY. Methotrexate is dosed once a week, NOT daily. Choose one fixed day of the week (e.g. Monday) and take all tablets together that day. Daily dosing by mistake is potentially fatal. This is the most common preventable serious medication error involving methotrexate.
- Folic acid 5 mg weekly on a different day (e.g. Friday) reduces nausea, mouth ulcers and LFT rise without significantly reducing efficacy.
- Bevehető étkezéssel vagy anélkül.
- Kötelező monitorozás: baseline FBC, LFTs (AST, ALT), U&E + creatinine, CXR. Repeat FBC + LFTs every 2 weeks for first 3 months, then monthly. Annual cumulative-dose tracking for hepatic fibrosis risk (specialist).
- Stop and seek same-day review for: severe mouth ulcers, severe diarrhoea, new dyspnoea or cough, fever, jaundice, easy bruising or bleeding, or unusual rash.
Mellékhatások
Gyakori: nausea, mouth ulcers, fatigue, hair thinning, mild LFT rise, mild cytopenia.
Fontos:
- Myelosuppression — neutropenia, thrombocytopenia, anaemia. Severe pancytopenia can occur with daily-dosing errors.
- Hepatotoxicitás — LFT rises common; cumulative-dose hepatic fibrosis with long-term use
- Pneumonitis — idiosyncratic; new dyspnoea or dry cough warrants stopping and review
- Renal impairment — accumulation toxicity
- Mucositis — often the rate-limiting side effect at higher doses
- Fényérzékenység
- Severe skin reactions (Stevens-Johnson syndrome) — rare but documented
Warnings — CRITICAL
- Pregnancy: ABSOLUTE CONTRAINDICATION (FDA Pregnancy Category X). Methotrexate is a potent teratogen and abortifacient. Reliable contraception throughout treatment AND for at least 3 months after the last dose in women, 6 months in men (some guidelines require 6 months in both).
- Breastfeeding: contraindicated — methotrexate excreted in breast milk.
- Veseelégtelenség: reduce dose for eGFR < 60 mL/min; avoid if eGFR < 30. Methotrexate is renally cleared and accumulates rapidly in renal failure with severe toxicity.
- Severe hepatic impairment, active alcoholism, hepatitis B/C: avoid — high risk of severe hepatotoxicity.
- Active infection: hold methotrexate during serious infection.
- Élő oltóanyagok (MMR, yellow fever, BCG, oral polio): contraindicated during methotrexate therapy.
- Pleural effusion or ascites: methotrexate accumulates in third-space fluid and re-releases, causing prolonged toxicity. Drain effusions before starting.
- NSAID interaction risk: see drug interaction table.
Gyógyszerkölcsönhatások
| Kombinálható | Hatás | Teendők |
|---|---|---|
| NSAIDs (ibuprofen, naproxen, diclofenac), aspirin (analgesic dose) | Reduce methotrexate clearance — toxicity risk; severe at high MTX doses, modest at low maintenance doses | Generally OK at stable low oral MTX doses with monitoring; avoid with high-dose IV MTX. Paracetamol is safer. |
| Trimethoprim, co-trimoxazole (Septrin) | Additive antifolate effect — severe pancytopenia | AVOID. Use alternative antibiotic. |
| Live vaccines (MMR, yellow fever, BCG, varicella) | Disseminated infection from live vaccine | Contraindicated. |
| PPIs (omeprazole) at high-dose IV methotrexate | Reduce MTX clearance | Hold PPIs around high-dose IV MTX (specialist). Generally OK at low oral doses. |
| Alkohol | Additív májmérgezés | Limit to occasional small amounts. No more than 1–2 drinks per week. |
| Probenecid, penicillins (high dose) | Reduce MTX renal clearance — toxicity | Kerülje a kombinációt. |
| Folic acid 5 mg weekly | Reduces toxicity (mucositis, GI, LFT rise) without significantly reducing efficacy | STANDARD — take 5 mg weekly on a different day from MTX. |
Tárolás
- Room temperature, 15–25°C, original blister.
- Keep out of reach of children, women of childbearing potential, and pets — methotrexate is a potent teratogen.
- Wash hands after handling tablets.
Kapcsolódó alternatívák a MedsBase-en
További onkológiai gyógyszerek, amelyek e termék mellett elérhetők:
Összes rákkel szembeni gyógyszer böngészése →
Gyakran Ismételt Kérdések
Why is methotrexate dosed weekly, not daily?
Methotrexate is dosed once a week (not daily) at low oncology-maintenance and rheumatology doses. Daily dosing of methotrexate by mistake is potentially fatal — it has caused multiple inquest-level adverse events worldwide and is one of the most common preventable serious medication errors. Pick one fixed day of the week (e.g. Monday), take all tablets together that day, and never dose more frequently. Tell every doctor and pharmacist about your weekly schedule.
Why do I take folic acid?
Folic acid 5 mg once weekly (on a different day from methotrexate, e.g. Friday) reduces the most common methotrexate side effects — nausea, mouth ulcers, GI upset, LFT rise — without significantly reducing efficacy. It is a standard part of every long-term methotrexate regimen.
Milyen vérvizsgálatokra van szükségem?
Baseline: FBC, LFTs (AST, ALT), U&E + creatinine, CXR. Then FBC + LFTs every 2 weeks for the first 3 months, then monthly. Annual cumulative-dose review for hepatic fibrosis risk (specialist). Tell your doctor about any infection, mouth ulcers, easy bruising, or jaundice.
Can I drink alcohol on methotrexate?
Limit alcohol to 1–2 standard drinks per week or less — both alcohol and methotrexate are hepatotoxic. Heavier drinking significantly raises the risk of methotrexate-induced liver damage and hepatic fibrosis on long-term therapy.
Can I get pregnant on methotrexate?
No — methotrexate is FDA Pregnancy Category X. Methotrexate is teratogenic and abortifacient. Reliable contraception is mandatory throughout treatment and for at least 3 months after the last dose in women and at least 6 months in men (some guidelines extend the female window to 6 months also). Discuss family planning with your specialist before starting; switch to a non-teratogenic alternative (azathioprine, sulfasalazine in some indications) if pregnancy planned.
Can I have live vaccines on methotrexate?
Live vaccines (MMR, yellow fever, BCG, oral polio, varicella) are contraindicated during methotrexate therapy — risk of disseminated infection from the vaccine virus. Inactivated vaccines (annual flu shot, pneumococcal, COVID-19, hepatitis B) are not only safe but recommended. Plan live vaccines at least 4 weeks before starting methotrexate, or 3 months after stopping.
What antibiotics are unsafe with methotrexate?
Trimethoprim and co-trimoxazole (Septrin/Bactrim) are the most dangerous — they have additive antifolate effects with methotrexate and have caused fatal pancytopenia. AVOID. Use alternative antibiotics — amoxicillin, doxycycline, cefalexin etc are safe. Tell every doctor about your methotrexate before any antibiotic is prescribed.
Why must I tell my doctor before any surgery?
Methotrexate impairs wound healing and increases infection risk. For elective major surgery, methotrexate is sometimes held for 1–2 weeks pre-op and resumed once the wound has healed. For minor surgery (skin biopsy, dental work) it can usually be continued. Specialist guidance.
Miért rendelj a MedsBase-ról
Minden tétel egy WHO-GMP tanúsított gyártó. WHO-GMP Újraküldési Garancia: ha egy csomag nem érkezik meg 20 munkanapon belül, ingyenes utánküldést biztosítunk, kérdések nélkül.
Kapcsolódó rákellenes gyógyszerek
További onkológiai gyógyszerek, amelyek e termék mellett elérhetők:
- Folitrax (methotrexate 2.5/7.5/10 mg)
- Imutrex (methotrexate 2.5/7.5/10 mg)
- Leetrexate (methotrexate 2.5/7.5/10 mg)
- Endoxan (cyclophosphamide 50 mg)
- Hydrosar (hydroxyurea 500 mg)
További lehetőségek az Antirákos Gyógyszerek között
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| Erősség | 2,5 mg |
|---|---|
| Mennyiség | 30 tabletta, 60 tabletta, 90 tabletta, 180 tabletta |
Noltrexate
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Noltrexate
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