Severe complications following low-dose application of methotrexate

Abstract

Methotrexate is a folate antagonist used to treat malignant tumors, mostly combined with other cytostatic drugs and/or radiotherapy. However, it can also be applied for therapy of chronic polyarthritis and other joint-destroying rheumatic diseases. Lowdose methotrexate (15–25 mg/week) is indicated as the basic therapeutic agent for these diseases. Even this low-dose therapy may damage bone marrow and thus cause potentially lethal infections. In the context of basic antirheumatic drug therapy, the use of methotrexate requires strict indications and frequent laboratory follow-ups. Interactions with other pharmaceutical agents must also be considered