. . . . . . . . . "indications and usage neoplastic disease methotrexate is indicated in the treatment of gestational choriocarcinoma chorioadenoma destuens and hydatidiform mole methotrexate is used in maintenance therapy in combination with other chemotherapeutic agents methotrexate is used alone or in combination with other anticancer agents in the treatment of breast cancer epidermoid cancers of the head and neck advanced mycosis fungoides cutaneous t cell lymphoma and lung cancer particularly squamous cell and small cell types methotrexate is also used in combination with other chemotherapeutic agents in the treatment of advanced stage non hodgkin s lymphomas psoriasis methotrexate is indicated in the symptomatic control of severe recalcitrant disabling psoriasis that is not adequately responsive to other forms of therapy but only when the diagnosis has been established as by biopsy and or after dermatologic consultation it is important that a psoriasis flare is not due to an undiagnosed concomitant disease affecting immune responses rheumatoid arthritis including polyarticular course juvenile rheumatoid arthritis methotrexate is indicated in the management of selected adults with severs active rheumatoid arthritis acr criteria or children with active polyarticular course juvenile rheumatoid arthritis who have had an insufficient therapeutic response to or are intolerant of an adequate trial of first line therapy including full dose non steroidal antiinflammatory agents nsaids aspirin nsaids and or low dose steroids may be continued although the possibility of increased toxicity with concomitant use of nsaids including salicylates has not been fully explored see precautions drug interactions steroids may be reduced gradually in patients who respond to methotrexate combined use of methotrexate with gold penicilamine hydroxychloroquine sulfasalazine or cytotoxic agents has not been studied any may increase the incidence of adverse effects rest and physiotherapy as indicated should be continued" . . . . . . "RSA" . "MIGfMA0GCSqGSIb3DQEBAQUAA4GNADCBiQKBgQCODwZkXojpEKwk7Ldj2oPPfCstvqrcpgCaTLo235K7ht9C7E1GCkLvUuL2b4VWXJTcZx/hxgDauR8hUeYq/lS6tfTL9yFZsnfl+PWYDyz7vv6N+wJVx2LL8bO6ntCjcOzvW2t2WUeF12Sb6b3I6uOYP0N8iQKts1WasY/yEYKAHQIDAQAB" . "DYipCtM1Z12KrwlD5TU8+quRWPmIH1y5tnsTxQC18G3eounHtNSG9WYnL//Erri2Szu5U1BDr92fCOAQF7CrAvkvhp7jCWho/uMKqgE0lobSEnKymug9MR1YhrnY4aqXm9gCspdio+ufBVPr6ZgYztNcX4KUSMsYqCZF+RSFspc=" . . "2021-06-14T09:06:41.066+02:00"^^ . . . . .