Brand name: methotrexate
Generic name: amethopterin, Rheumatrex, Emthexate, Methoblastin, MTX

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This indicates that NSAIDs may enhance the toxicity of methotrexate. Cutaneous lesions partially remitted following infliximab discontinuation and methotrexate treatment. Methotrexate elimination is reduced in patients with impaired renal function, ascites, or pleural effusions. No interference occurs, however, if methotrexate is measured by a radioimmunoassay (RIA). Necrotizing fasciitis resulting in death has been reported in a 54-year-old man with rheumatoid arthritis receiving infliximab every 8 weeks along with intramuscular methotrexate weekly dosage. Patients treated with concomitant methotrexate had a lower rate of antibody development than patients on Humira monotherapy (1% versus 12%). Patients treated with methotrexate should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice. Antibodies developed in 12% of patients on adalimumab monotherapy and in 1% of patients on concurrent methotrexate.

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