The doctor will decide the dose, how often, and for how long a patient will receive it.
It depends on the patient’s general health and other factors, such as weight, age, blood tests, how well the kidneys and liver are working, and if other medicines are being given at the same time.
Methotrexate can be given into a vein in one of the following ways:
- Via a short, thin tube that the nurse inserts into a vein in the arm or hand (cannula)
- Via a thin tube that passes under the skin of the chest and into a nearby vein (central line)
- Via a thin tube that is inserted into a vein in the arm and goes up into a vein in the chest (PICC line).
Methotrexate can also be given:
- As tablets or liquid (oral medication)
- By injection into the fluid surrounding the spinal cord (intrathecal chemotherapy). This allows the drug to reach the spinal cord and the brain.
- By injection into a muscle (intramuscular injection)
High dose methotrexate
Monitoring methotrexate levels is essential because delayed excretion of methotrexate is potentially an emergency. Methotrexate levels are monitored every 24 hours from administration until the drug is excreted at safe levels (below 0.5).
Methotrexate is eliminated renally (via the kidneys). Renal function should be assessed prior to treatment.
