What is an Imutrex Tablet?

Imutrex contains methotrexate which is an antirheumatic drug. It is used in rheumatoid arthritis in addition to NSAIDs. It is also referred to as a disease-modifying antirheumatic drug. It is a non-biological drug. 

The immunoglobulin IgM is responsible for activating the complement system and for the release of cytokinesis which is chemotactic for neutrophils. Prostaglandin is produced in the process which causes vasodilation and pain. Imutrex is recommended to be added to NSAIDS as soon as the diagnosis of rheumatoid arthritis is confirmed.

It is also used to treat severe psoriasis, Pemphigus, myasthenia gravis, uveitis, chronic active hepatitis. It is manufactured by Cipla Limited.

How Does Imutrex Tablet Treat Rheumatoid Arthritis and Psoriasis?

These are the only drugs other than corticosteroids that can suppress the rheumatoid process and bring about remission and retard the disease progression. However, It does not have a non-specific anti-inflammatory or analgesic action. 

Rheumatoid arthritis is a crippling disorder with a chronic progression and a waxing and waning course. Multiple small joints of hands and feet are preferentially affected in this disease and deformities are produced as the disease progresses.

In unresponsive Psoriasis, it inhibits the rapid multiplication of cells which usually build up to form dry, scaly patches with itching.

Directions of Use

Imutrex tablets are supposed to be taken orally and the patient should swallow it whole along with water. Do not crush it or try to chew the tablet. The number of times that this tablet is to be taken will be decided by your doctor and you should follow it properly.

How Long Does it Take for Imutrex Tablet to Work?

The onset of symptoms relief by methotrexate is relatively rapid. It is visible in 3 to six weeks. This has led to the acceptance of methotrexate as a preferred drug for initial treatment. Methotrexate is now a disease-modifying antirheumatic drug of first choice and the standard treatment for most patients, including cases of juvenile rheumatoid arthritis.

What are the Dosage Instructions for Imutrex Tablet?

The introduction of low oral doses of around 7.5 to 15 milligram weekly has led to improved methotrexate acceptability in cases of rheumatoid arthritis. The onset of benefit with this treatment takes a few months of regular use, and relapse occurs at least up to a few months after the cessation of therapy. 

Therefore it is important to stick to the routine prescribed by your consulting medical health personnel. Do not change it according to your own accord. Your dosage is prescribed based on what works the best for you including your age, the severity of your presenting symptoms, and your response to therapy.

For treatment of carcinoma, a 15 to 30 milligram per day dosage of methotrexate is prescribed for five days orally. High-dose methotrexate can induce remission in childhood acute lymphoblastic leukemia and is also effective in the maintenance of remission, showing that the disease may be cured. Methotrexate is widely used in breast, bladder, head and neck cancer, and osteogenic sarcoma.

Overdose

Patients should be warned about the key symptoms of methotrexate toxicity that occur due to overdosing such as the development of a sore throat, mouth ulcers, getting a fever, development of a dry persistent cough, vomiting, or diarrhea. Report it to your doctor if you experience any of these symptoms, especially if you have overused this medicine by mistake.

Missed Dose

In case you skip a dose, take the next dose as soon as you remember it; however if the time for the next door is already near then forget about the skipped dose and start following the original routine. 

Do not double the dose or overdose the medicine to make up for the dose that has been missed by you as it will make it harder and good and it may lead to the development of harmful symptoms that occur due to overdosing. 

Sub Products of Imutrex Tablet

• Imutrex tablet 2.5mg
• Imutrex tablet 7.5mg
• Imutrex tablet 10mg
• Imutrex tablet 15mg
• Imutrex Injection 30mg/2ml

Mechanism of Action

Methotrexate is a dihydrofolate reductase inhibitor and it has a prominent immunosuppressive and anti-inflammatory property. It is beneficial in rheumatoid arthritis as it inhibits cytokine production and chemotaxis and cell-mediated immune response. 

The proliferation of immune-inflammatory cells is inhibited. Its response is more predictable and sustained over the long term. Combination regimens of two or three disease-modifying antirheumatic drugs mostly include methotrexate.

It is a highly efficacious antineoplastic drug. It blocks the conversion of dihydro folic acid to Tetrahydro folic acid. Utilizing the folate carrier it enters into cells and is transformed into a more active polyglutamate form by the enzyme folylpolyglutamate synthase. It has a cell cycle-specific action and it kills the cells in the S phase.

Adverse Side Effects

• Methotrexate can cause oral ulceration.
• Gastrointestinal upsets are the major side effects of a low-dose methotrexate regimen.
• Progressive liver damage leading to cirrhosis occurs in some patients who have been undergoing prolonged therapy. However, this is not seen with short courses used for cancer.
• Incidences of chest infection have also increased.
• Its toxicity is very high when it is used in the treatment of inflammatory bowel disease as its dosage is higher when compared to that needed in rheumatoid arthritis. Its efficacy in ulcerative colitis is very poor.
• Abdominal pain is a frequently reported side effect
• Indigestion may occur
• Loss of appetite is commonly experienced
• Nausea
• Some patients experience Tiredness
• Some patients also develop a Mouth sore 
• While inhibiting DNA synthesis in cancerous cells, the synthesis of RNA and proteins is also affected
• It exerts major toxicity on bone marrow and is repeatedly given low doses that cost megaloblastic anemia.
• High doses produce pancytopenia.
• Mucositis and diarrhea are also common side effects.
• Desquamation and bleeding may occur in the gastrointestinal tract.

Warnings and Precautions

1. Probenecid and aspirin increase methotrexate levels and toxicity caused by it by decreasing its renal tubular secretion.
2. Trimethoprim can add to inhibition of dihydrofolate reductase and depressed bone marrow.
3. Drugs like Salicylates, sulfonamides, and dicumarol displace them from the protein binding sites.
4. Methotrexate is severely harmful if taken during pregnancy and breastfeeding.
5. Patients with liver diseases and peptic ulcers should also use this medicine with caution.
6. Inform your doctor if you have any active infection or leukopenia before taking this medication.
7. Death has been reported in some cases where treatment was going on for cancer.
8. Its toxicity needs to be monitored in cases of pleural effusion as its excretion becomes low.
9. Its toxicity is not countered by folic acid which is antagonized by folinic acid.
10. Take folic acid when taking methotrexate tablets.
11. It is important to drink plenty of water and to stay well hydrated at all times.

Who Should Not Take It? 

• It is not recommended for patients of renal disease as oral bioavailability of methotrexate is variable and it may be affected by food, its excretion is also hindered in renal diseases.
• In case you are allergic to any of its compositions, you should not take it.
• Couples who are planning for a child should also not take it.

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FAQs

Is it safe to drive when using Imutrex tablets?

It is unsafe to drive when undergoing this treatment and you are recommended to observe caution.

Is it safe to use alcohol along with Imutrex tablets?

No, do not use alcohol when undergoing this treatment, inform your doctor about it.

Can Imutrex tablets affect fertility?

Yes, these tablets decrease the sperm count in men and cause disturbances in the menstrual cycle in females. However, these effects are temporary and normalcy will be restored after the therapy is completed. However, a woman should not attempt to get pregnant if either of the partners is using this treatment as it can cause severe birth defects.

Can patients with liver diseases use this?

No, prolonged use of methotrexate can cause Hepatic toxicity, cirrhosis, and fibrosis of the liver.

Are Imutrex tablets safe for use during breastfeeding?

No, do not use this treatment if you are a breastfeeding woman.

Imutrex Tablet Alternatives

• Methorex 2.5mg Tablet
• Methocel 2.5mg Tablet
• Trex 2.5mg Tablet
• Remtrex 2.5mg Tablet
• Neotrexate Tablet
• Folitrax 2.5 Tablet
• Oncotrex 2.5mg Tablet
• Biotrexate 2.5mg Tablet
• Mexate 2.5 Tablet

Conclusion 

Methotrexate is used only in patients with chronic diseases who have not responded to most other treatments, however, it is very useful in treating a variety of autoimmune diseases. Store it in a cool and dry place at a temperature below 30 degrees Celsius, keep it away from direct heat, humidity and therefore store it in a cool and dry place. It can be harmful if ingested by kids or pets. This medicine can be availed after getting a doctor’s prescription.