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Imutrex 2.5 mg contains Methotrexate, a folate antagonist that inhibits DNA and RNA synthesis, thereby preventing cell proliferation. It is recommended as a first-line systemic therapy for rheumatoid arthritis (RA) and moderate to severe psoriasis, and at higher doses, it is also used in the treatment of certain malignancies such as choriocarcinoma and acute lymphoblastic leukemia (ALL).

Imutrex is classified under antimetabolites and antineoplastic agents. Its mechanism of action involves tight binding to the enzyme dihydrofolate reductase (DHFR), thereby preventing the conversion of folate to tetrahydrofolate. This inhibition disrupts purine and thymidylate synthesis, leading to cell cycle arrest, particularly in rapidly dividing tissues such as tumor cells, epithelial tissues, and immune cells.

Indications include the treatment of rheumatoid arthritis, severe psoriasis unresponsive to topical therapy, choriocarcinoma, osteosarcoma, acute leukemias, non-Hodgkin lymphomas, trophoblastic tumors, and certain carcinomas (including breast, lung, cervical, ovarian, and prostate cancers).

Contraindications include patients with severe hepatic or renal impairment, bone marrow suppression, immunodeficiency, and pregnancy.

Dosage: Imutrex is usually administered at a dose of 2.5–7.5 mg once weekly, strictly under medical supervision. Overdosage can lead to severe hematologic, hepatic, or gastrointestinal toxicity. Regular monitoring of CBC, liver function, and renal function tests is essential during treatment.

Common side effects include nausea, stomatitis, hair loss (alopecia), elevated liver enzymes, and photosensitivity. Concomitant use with nonsteroidal anti-inflammatory drugs (NSAIDs), sulfonamides, or tetracyclines should be approached with caution due to potential drug interactions and increased risk of toxicity.