Effect

• High dose: chemotherapy agent
  • Cytotoxic Agents
• Low dose: inflammatory diseases (once weekly)
  • Folic acid given on the other days to counter the chemo side effect
  • Anti-metabolites

Application

• Immunosuppression drugs

  <aside>

  • RA - Rheumatoid Arthritis (1 st line DMARD) </aside>

  • Psoriasis

  • Atopic Dermatitis (Eczema)

  • Other SARD

• Therapeutic Abortion & Termination

• !Ectopic Pregnancy

  • Preferred characteristics:
    • Mild symptoms (no headache etc)
    • Absent embryonic heart beat

A/E

• Bone Marrow (Myelo-) suppression
• Higher risk of Infection
• GI toxicity
• Transaminitis
• Mucositis
  • ILD - Interstitial Lung Disease
  • Oral ulcers
  • Gastritis
• Fatigue
• drug interactions
  • TMP-SMX (Septra)
  • NSAID

Absolute CI (for !Ectopic Pregnancy)

• Unstable (HR, BP dropping)