Please describe the indication, caution, and side effect of methotrexate use in uveitis and iritis patients

Methotrexate may be indicated for patients with uveitis and iritis in cases where the inflammation is non-infectious, chronic, or unresponsive to corticosteroid treatment.
Methotrexate can help manage symptoms, reduce inflammation, and prevent vision loss.

Methotrexate is contraindicated in patients with:
Known hypersensitivity or allergy to methotrexate or its components.
Severe liver or kidney disease.
Pre-existing blood disorders, such as bone marrow suppression or severe anemia.
Active infections or immunodeficiency.
Pregnancy or breastfeeding, due to potential harm to the fetus or infant.

Methotrexate should be used with caution in patients with certain medical conditions, including mild to moderate liver or kidney disease,
lung problems, or a history of blood disorders.
Patients taking methotrexate should have regular blood tests to monitor liver function, kidney function, and blood cell counts.
Methotrexate may also interact with other medications, so it’s important to discuss all medications being taken with a healthcare professional.

Side Effects:
Methotrexate can cause a range of side effects, which may include:
1. Gastrointestinal issues, such as nausea, vomiting, diarrhea, or mouth sores.
2. Fatigue and dizziness.
3. Increased risk of infections due to its immunosuppressive properties.
4. Hair loss or thinning.
5. Headaches.
6. Skin rashes or sensitivity to sunlight.
7. Abnormal liver function tests, which may indicate liver damage.
8. Bone marrow suppression, which can lead to anemia, low white blood cell counts, and an increased risk of infections and bleeding.

While many patients experience mild side effects, some may experience more severe or life-threatening side effects.
It is essential to monitor side effects and communicate any concerns to a healthcare professional.
They may adjust the dosage or switch to an alternative medication if necessary.

Remember, this information is for general purposes only, and it is crucial to consult a healthcare professional for
personalized advice on the use of methotrexate for uveitis and iritis patients.

長庚醫院 林口醫學中心 眼科部部長 葡萄膜炎/虹彩炎/視網膜科 黃奕修 教授 執筆
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