title: Methotrexate: a detailed review  on drug delivery and clinical  aspects.
abstract: BACKGROUND
  Uses of methotrexate (MTX) are well established for the treatment of various types of malignancy, psoriasis, rheumatological diseases and the medical termination of pregnancy. Formulation and targeting approaches for MTX with controlled release carriers, multiparticulate systems, prodrug and drug conjugates have been found to improve bioavailability, reduce adverse effects and maximize clinical efficacy, compared with conventional methods.
  
  
  METHODS
  This exhaustive literature survey on different electronic databases covers drug delivery and clinical trials on MTX. This review deals with the challenges and achievements of controlled release, multiparticulate, prodrug and drug conjugate systems of MTX.
  
  
  CONCLUSIONS
  Therapeutic drug monitoring of MTX is crucial to attain a good efficacy. In spite of the advantages of multiparticulate, prodrug and drug conjugates, clinical applications of such formulations of MTX are still under infancy. These drug delivery systems require the special attention of medical experts for its wider clinical usage, and pharmaceutical experts for its scale-up. The combination of MTX with other antineoplastic and immunosuppressants should also be subjected to clinical trials, such as the combination of misoprostol with MTX in abortion.
authors.affiliation: Banaras Hindu University, Institute of Technology, Department of Pharmaceutics, Varanasi, India.
authors.forename: Zulfequar Ahamad
authors.initials: ZA
authors.lastname: Khan
authors.forename: Rahul
authors.initials: R
authors.lastname: Tripathi
authors.forename: Brahmeshwar
authors.initials: B
authors.lastname: Mishra
mesh_terms: D000028:Abortion, Induced / Q000379:methods; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000971:Antineoplastic Combined Chemotherapy Protocols; D000977:Antiparasitic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001682:Biological Availability; D002626:Chemistry, Pharmaceutical; D003692:Delayed-Action Preparations; D004333:Drug Administration Routes; D004338:Drug Combinations; D016503:Drug Delivery Systems; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008081:Liposomes; D008727:Methotrexate / Q000008:administration & dosage* / Q000493:pharmacokinetics; D016595:Misoprostol / Q000008:administration & dosage; D053758:Nanoparticles; D011247:Pregnancy; D011355:Prodrugs
chemical_list: D000970:Antineoplastic Agents; D000977:Antiparasitic Agents; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D008081:Liposomes; D011355:Prodrugs; D016595:Misoprostol; D008727:Methotrexate