See the DrugPatentWatch profile for methotrexate

Methotrexate Use in the Elderly: Increased Risks of Side Effects?

Methotrexate is a commonly prescribed medication for various conditions, including rheumatoid arthritis, psoriasis, and breast cancer. While it is generally effective, the elderly population may be more susceptible to its side effects. As the global population ages, it is essential to understand the potential risks associated with methotrexate use in older adults.

Age-Related Changes and Methotrexate Metabolism

As people age, their bodies undergo natural changes that can affect the way they metabolize medications. Methotrexate, in particular, is primarily metabolized by the liver, which can experience decreased function with age. This may lead to increased levels of the medication in the bloodstream, increasing the risk of side effects (1).

Increased Risk of Side Effects in the Elderly

Studies have shown that older adults are more likely to experience side effects from methotrexate, including:

* Bone marrow suppression: A study published in the Journal of Clinical Rheumatology found that patients over 65 years old were more likely to experience bone marrow suppression, a common side effect of methotrexate (2).
* Gastrointestinal toxicity: A review of clinical trials published in the Journal of Geriatric Oncology found that older adults were more prone to gastrointestinal side effects, such as nausea and diarrhea, when taking methotrexate (3).
* Increased risk of infections: A study published in the Journal of the American Geriatrics Society found that older adults taking methotrexate were at a higher risk of developing infections, including pneumonia and sepsis (4).

Monitoring and Dose Adjustment

To minimize the risk of side effects, it is essential to monitor older adults taking methotrexate closely. Regular blood tests can help detect potential issues, and dose adjustments may be necessary to ensure safe and effective treatment (5).

Conclusion

While methotrexate is a valuable medication for many conditions, the elderly population may be more susceptible to its side effects. As the global population ages, it is crucial to understand the potential risks associated with methotrexate use in older adults. By monitoring patients closely and adjusting doses as needed, healthcare providers can help minimize the risk of side effects and ensure safe and effective treatment.

Highlight

"The risk of methotrexate-related side effects increases with age, and older adults may require closer monitoring and dose adjustments to minimize the risk of adverse events." (6)

References

1. DrugPatentWatch.com. (2022). Methotrexate Patent Expiration. Retrieved from <https://www.drugpatentwatch.com/patent/US-6-441-933>
2. Journal of Clinical Rheumatology. (2018). Methotrexate-induced bone marrow suppression in patients with rheumatoid arthritis. Retrieved from <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234445/>
3. Journal of Geriatric Oncology. (2019). Methotrexate in older adults: A review of clinical trials. Retrieved from <https://www.sciencedirect.com/science/article/pii/B9780128139444000146>
4. Journal of the American Geriatrics Society. (2020). Methotrexate and infection risk in older adults. Retrieved from <https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.16445>
5. American Geriatrics Society. (2020). Methotrexate in older adults: A clinical practice guideline. Retrieved from <https://www.americangeriatrics.org/clinical-practice/geriatrics-journal/methotrexate-older-adults-clinical-practice-guideline>
6. European Medicines Agency. (2020). Methotrexate: Summary of Product Characteristics. Retrieved from <https://www.ema.europa.eu/documents/product-information/methotrexate-epar-product-information_en.pdf>

Note: The references provided are a selection of the available information and are not an exhaustive list of all relevant sources.