Name of the Procedure:

Common name(s): Methotrexate (oral) Technical/medical term: Methotrexate; oral, 2.5 mg (HCPCS code: J8610)

Summary

Methotrexate is a medication taken orally in a 2.5 mg tablet form. It is used to treat various medical conditions by slowing the growth of rapidly dividing cells, such as cancer cells, and by reducing immune system activity.

Purpose

Methotrexate is used to:

• Treat certain cancers (e.g., breast cancer, lung cancer).
• Manage autoimmune diseases (e.g., rheumatoid arthritis, psoriasis).
• Provide anti-inflammatory effects.

The goals are to reduce or eliminate cancerous cells, decrease inflammation, and manage autoimmune symptoms.

Indications

• Diagnosed with specific types of cancer.
• Suffering from autoimmune diseases, such as rheumatoid arthritis or psoriasis.
• Symptoms of chronic inflammation that require immune system suppression.

Preparation

• Discuss your full medical history and current medications with your doctor.
• No special dietary restrictions or fasting needed for oral methotrexate.
• Regular blood tests may be required to monitor liver function and blood cell counts.

Procedure Description

1. Prescription: Methotrexate is prescribed by your healthcare provider.
2. Administration: Taken orally as a 2.5 mg tablet.
3. Frequency: Typically once a week, but your doctor will provide specific instructions.
4. Monitoring: Regular blood tests and follow-up visits to monitor effectiveness and side effects.

Duration

Taking the medication itself takes just a few moments, but the treatment course is usually ongoing and determined by your medical condition and physician's assessment.

Setting

Performed at home after obtaining the medication from a pharmacy. Regular monitoring might require visits to a clinic or healthcare provider's office.

Personnel

• Prescribing physician (e.g., oncologist, rheumatologist).
• Pharmacist for dispensing the medication.
• Nursing and support staff for follow-up care and monitoring, if needed.

Risks and Complications

• Common: Nausea, vomiting, mouth sores, fatigue, low blood cell counts.
• Rare: Liver toxicity, lung disease, severe infections, allergic reactions.
• Management: Regular blood tests, liver function tests, and close communication with your healthcare provider.

Benefits

• Reduction or elimination of cancer cells.
• Improvement in symptoms of autoimmune diseases.
• Decrease in chronic inflammation. Benefits might be realized within weeks to months, depending on the condition treated.

Recovery

• Follow prescribed dosing strictly and adhere to follow-up appointments.
• Report any severe side effects or unusual symptoms to your healthcare provider immediately.
• Continue with regular blood tests as recommended.

Alternatives

• Other chemotherapy agents.
• Biologic agents or targeted therapies.
• Non-drug treatments like physical therapy for autoimmune conditions. Pros: Alternatives may have different side effect profiles or mechanisms of action. Cons: They may not be as effective for some patients or could have other risks and complications.

Patient Experience

• During: Swallowing the tablet is straightforward and done at home.
• After: Patients might experience side effects such as nausea and fatigue; these can often be managed with supportive care measures. Pain management is generally not necessary, but patients should communicate any discomfort or adverse effects to their healthcare provider for appropriate management.