Bibek Subedi*
Methotrexate is a commonly prescribed medication in clinical practice. Many dermatologists, rheumatologists and oncologists prescribe this medication. However, due to a lack of understanding of patients or in the hope of early relief of symptoms, patients tend to use higher and more frequent doses than recommended resulting in several side effects. In this case series, we report five cases of methotrexate toxicity due to accidental and over jealous use prescribed for underlying disorders. All presented with fever, skin and mucosal lesions. All the patients had deranged hematological parameters. This article discusses the presentations and management of methotrexate overdose in a resource-poor setting. Out of five admitted cases, three recovered completely with the resolution of skin and mucosal lesions and improved hematological parameters while two patients succumbed to illness. Prompt identification of symptoms and early management are required to improve overall outcomes.
