See the DrugPatentWatch profile for methotrexate

Yes, methotrexate can impact older adults differently. Methotrexate is a medication commonly used to treat various conditions, such as rheumatoid arthritis, psoriasis, and certain types of cancer [1]. However, older adults may experience unique side effects and complications due to age-related physiological changes and the potential for multiple medication use [2].

One significant concern in older adults is methotrexate-induced myelosuppression, which can lead to decreased production of white and red blood cells and platelets, increasing the risk of infections, anemia, and bleeding [1][2]. Additionally, older adults may be more susceptible to gastrointestinal side effects, such as nausea, vomiting, and diarrhea, which can impact nutrient absorption and overall health [1].

Renal function decline is also a concern in older adults, as methotrexate is primarily excreted by the kidneys [1]. Reduced renal function can lead to increased methotrexate concentrations in the body, increasing the risk of toxicity [1]. Therefore, dose adjustments and monitoring of renal function are crucial in older adults [2].

Furthermore, older adults are more likely to use multiple medications, increasing the risk of drug-drug interactions [2]. Methotrexate interacts with several medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), and some antibiotics, which can affect methotrexate's absorption, metabolism, and elimination [1].

In conclusion, while methotrexate is an effective treatment for various conditions, older adults may experience unique side effects and complications due to age-related physiological changes and polypharmacy [1][2]. Therefore, careful monitoring and dose adjustments are necessary to ensure the safe and effective use of methotrexate in older adults [2].

Sources:
[1] Methotrexate. Lexicomp Online, Hudson, Ohio: Wolters Kluwer Health; 2021.
[2] American Geriatrics Society 2019 Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-694. doi:10.1111/jgs.15767. <https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.15767>
[3] Methotrexate. DrugPatentWatch.com. <https://www.drugpatentwatch.com/drugs/methotrexate>