Methodject - Instructions For Use, Price, Reviews, Analogues

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Methodject

Methodject: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Application during pregnancy and lactation
10. 10. Use in childhood
11. 11. In case of impaired renal function
12. 12. For violations of liver function
13. 13. Use in the elderly
14. 14. Drug interactions
15. 15. Analogs
16. 16. Terms and conditions of storage
17. 17. Terms of dispensing from pharmacies
18. 18. Reviews
19. 19. Price in pharmacies

Latin name: Metoject

ATX code: L01BA01

Active ingredient: methotrexate (methotrexate)

Producer: Oncotec Pharma Produktion (Germany)

Description and photo update: 2018-23-10

Prices in pharmacies: from 585 rubles.

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Methodject - antimetabolite, anticancer drug.

Release form and composition

Dosage forms of Methodject:

• solution for subcutaneous (s / c) administration: clear liquid from yellow-brown to yellow (7.5 mg / 0.15 ml, 10 mg / 0.2 ml, 12.5 mg / 0.25 ml, 15 mg / 0.3 ml, 17.5 mg / 0.35 ml, 20 mg / 0.4 ml, 22.5 mg / 0.45 ml, 25 mg / 0.5 ml, 27.5 mg / 0, 55 ml or 30 mg / 0.6 ml in a glass syringe without color with a capacity of 1 ml, in a blister 1 filled syringe connected to a needle for subcutaneous administration, closed with a rubber stopper, in a cardboard box 1 blister);
• solution for injection: transparent yellow liquid (1 ml, 0.75 ml, 1.5 ml, 2 ml or 2.5 ml each in a glass syringe, in a blister 1 syringe complete with a needle or needles, in a cardboard box 1 blister).

1 ml of solution for subcutaneous administration contains:

• active substance: disodium methotrexate - 54.84 mg, which corresponds to 50 mg of methotrexate (prepared according to the recipe: methotrexate - 50 mg, sodium hydroxide - 9.6 mg);
• auxiliary components: sodium chloride, sodium hydroxide, water for injection.

1 ml of solution for injection contains:

• active substance: disodium methotrexate - 10.96 mg, which corresponds to 10 mg of methotrexate (prepared according to the recipe: methotrexate - 10 mg, sodium hydroxide - 1.76 mg);
• auxiliary components: sodium chloride, sodium hydroxide, water for injection.

Pharmacological properties

Pharmacodynamics

Methodject is a cytotoxic drug, is an antagonist of folic acid, an antimetabolite. It has antitumor and immunosuppressive effects. Antitumor activity is aimed at inhibiting the synthesis of deoxyribonucleic acid (DNA), which occurs due to the competitive inhibition of the enzyme dihydrofolate reductase, which is involved in the conversion of dihydrofolic acid to tetrahydrofolic acid. Tetrahydrofolic acid is a carrier of carbon fragments involved in the synthesis of purine nucleotides and their derivatives.

It is not known whether the effectiveness of methotrexate in the treatment of rheumatoid arthritis (including juvenile chronic arthritis), psoriasis and psoriatic arthritis is due to either its immunosuppressive effect or its anti-inflammatory effect.

The degree of influence of the increase in the extracellular concentration of adenosine caused by methotrexate at the sites of inflammation has not been established on the effectiveness of therapy.

Pharmacokinetics

The bioavailability of methotrexate is almost 100% regardless of the route of administration.

About 50% of the administered dose binds to plasma proteins.

Methotrexate in the form of polyglutamates, after distribution, is found in high concentrations in the tissues of the kidneys, liver and especially the spleen. Here it can persist for a long time, up to several months.

When treated with small doses, the cerebrospinal fluid accumulates in a minimum amount.

The half-life is characterized by high variability, it can range from 3 to 17 hours. In the presence of pleural effusion or ascites, an additional volume of distribution appears, which can increase the elimination half-life by 4 times.

In the liver, about 10% of the administered dose is metabolized. The main metabolite of methotrexate is 7-hydroxymethotrexate, it has pharmacological activity.

In unchanged form, the drug is excreted mainly by the kidneys as a result of glomerular filtration and tubular secretion.

Approximately 5–20% of methotrexate and 1–5% of its main metabolite are excreted in the bile. Their subsequent significant reabsorption occurs in the intestine.

In case of impaired renal function, the elimination process is significantly slowed down. The effect of liver dysfunction on the period of methotrexate elimination has not been established.

Indications for use

• polyarthritis against the background of an active form of severe juvenile chronic arthritis in the absence of an adequate therapeutic effect from non-steroidal anti-inflammatory drugs;
• active form of rheumatoid arthritis in adult patients;
• severe generalized forms of psoriasis and psoriatic arthritis in adult patients with no effect of conventional therapy (including phototherapy, PUVA therapy, retinoid therapy).

Contraindications

• alcoholism;
• liver failure;
• severe renal failure with creatinine clearance (CC) less than 20 ml / min;
• bone marrow hypoplasia, thrombocytopenia, leukopenia, severe anemia and other hematopoietic disorders in history;
• severe immunodeficiency;
• an acute or chronic form of a severe infectious disease, including tuberculosis, HIV infection;
• active phase of gastrointestinal (GIT) peptic ulcer;
• mouth ulcers;
• simultaneous vaccination with live vaccines;
• period of pregnancy;
• breast-feeding;
• age up to 3 years;
• individual intolerance to the components of the Methodject.

Caution should be exercised when prescribing the solution for injection to patients with the following concomitant diseases or conditions: ascites, gastric ulcer and duodenal ulcer, obstructive gastrointestinal pathologies, ulcerative colitis, dehydration, vomiting, diarrhea, peritoneal or pleural effusion, chronic renal failure, infectious and parasitic diseases of viral, bacterial or fungal etiology (including history and recent contact with the patient) - viremic phase of herpes zoster, herpes simplex, chickenpox, amebiasis, measles, strongyloidosis, including if it is suspected (risk of developing severe generalized form); urate nephrourolithiasis (including history), gout (including history), inflammation and infections of the oral mucosa, asthenia, the period after chemotherapy or radiation therapy, old age.

Instructions for use of the Method: method and dosage

Solution for subcutaneous administration

The Methodject solution is used only for subcutaneous injections, the needle integrated into the syringe is already adapted for this.

The contents of the syringe are intended for single administration only; it is prohibited to mix it with other drugs.

The patient should be clearly informed of the single weekly dosing regimen.

Recommended dosage for subcutaneous administration of the Method in adults:

• rheumatoid arthritis: starting dose - 7.5 mg. Provided that it is well tolerated and to achieve a therapeutic effect, a single dose can be gradually increased by 2.5 mg per week. A single dose should not exceed 25 mg due to the high toxicity of the drug. The clinical effect of the drug usually occurs after 4–8 injections. In the future, for the appointment of a maintenance dose, the initial dose is gradually reduced to the lowest effective dose. Treatment is carried out for a long time (up to 10 years and longer);
• psoriasis and psoriatic arthritis: a test dose of 5-10 mg should be given 7 days before starting treatment. In the absence of intolerance reactions, the patient is prescribed an initial dose of 7.5 mg. In the future, the dose is gradually increased, usually up to 25 mg. The clinical effect occurs after 2–6 injections. To prescribe a maintenance dose, the dose used is reduced to the lowest effective dose. The maximum dose is 30 mg per week (used only in exceptional, clinically justified cases).

When the doctor decides to introduce the Methodject by the patient, he must independently be trained in the technique of performing subcutaneous injections. In this case, the patient should carry out the first self-injection in the presence of a doctor.

Method of drug administration

Introduction Methodject requires compliance with standard hygiene and aseptic requirements. Wash your hands thoroughly before the procedure.

1. You should make sure that the dosage of the syringe corresponds to the prescribed dose and check the expiration date of the solution.
2. After opening the package and the blister containing the filled syringe with the drug, visually check the solution for the absence of foreign particles in it. If foreign particles are found, the solution cannot be used.
3. Having prepared a syringe with the drug, choose a site for injection [subcutaneous injections can be carried out on the stomach (not higher than the level of the lower rib and at a distance of 5 cm around the navel) and on the thigh (palm-width above the knee and below the inguinal fold)]. Do not inject the drug into dense areas of the body or having soreness, violation of the integrity of the skin, redness or hematoma.
4. Having taken the desired position (sitting or lying), treat the selected injection site with a disinfectant napkin or a swab soaked in 70% ethanol solution, wait 30 seconds. At this time, pulling and simultaneously turning, remove the protective cap from the needle. Do not allow the sterile needle to touch any objects!
5. Fully insert the needle at an angle of 90 degrees into the skin fold formed between the fingers and slowly and evenly squeeze the entire volume of the drug out of the syringe.
6. After injecting the solution, remove the needle at the same angle and cover (do not rub!) The injection site with a sterile gauze bandage or a sterile swab. You can use an adhesive plaster if necessary.

You cannot enter the Method in a standing position.

Each subsequent injection should be given in a new location.

Injection

The Methodject solution is intended for s / c, intramuscular (i / m) or intravenous (i / v) administration.

For intramuscular and intravenous administration, it is necessary to use special needles, since the needle in the package can only be used for subcutaneous injection.

The use of each of the Methodject forms is shown once a week. It is recommended to set a specific day of the week for the introduction.

Treatment should be performed by a physician experienced with methotrexate.

The doctor determines the dose and duration of therapy individually.

The recommended dosage for intramuscular, intravenous and subcutaneous administration of the Method in adults:

• rheumatoid arthritis: starting dose - 7.5 mg. With good tolerance and to achieve a therapeutic effect, a single dose can be gradually increased by 2.5 mg per week. A single dose should not exceed 25 mg due to the high toxicity of the drug. The clinical effect of the drug usually occurs after 4–8 injections. Then, to prescribe a maintenance dose, the initial dose should be gradually reduced to the lowest effective dose. Long-term treatment, may exceed 10 years;
• psoriasis and psoriatic arthritis: A test dose of 5-10 mg should be given one week before starting treatment. In the absence of intolerance reactions, the patient is prescribed an initial dose of 7.5 mg. The dose is then gradually increased, usually up to 25 mg. The clinical effect occurs after 2–6 injections. To prescribe a maintenance dose, the dose used should be reduced to the lowest effective dose. The maximum dose - 30 mg per week, can be used only in exceptional, clinically justified cases.

When switching from the oral form of methotrexate to parenteral therapy, there may be a need to reduce the dose. This is due to differences in drug bioavailability.

According to current treatment standards, Methodject should be used in combination with folic acid preparations.

In the treatment of the polyarthritic form of juvenile chronic arthritis in children under the age of 16, only intramuscular administration of the drug is indicated. A single dose of methotrexate is recommended to be determined at the rate of 10-15 mg per 1 m ² of body surface. In the absence of a sufficient clinical effect, the dose can be increased to 20 mg per 1 m ² per week.

Special categories of patients

In case of renal failure, dose adjustment of Methodject is required depending on the QC indicator:

• CC more than 50 ml / min: usual dose;
• CC 20-50 ml / min: 50% of the usual dose;
• CC less than 20 ml / min: the use of the drug is prohibited.

In case of liver failure with a bilirubin concentration of more than 5 mg / dL (85.5 μmol / L), the use of methotrexate is contraindicated.

With great caution, Methodject should be used in case of severe liver dysfunction (including history), especially if they have arisen against the background of alcohol consumption.

When prescribing the drug to patients in old age, one should take into account possible changes in the reserve of folates in the body and age-related disorders of the kidneys and liver.

In patients with pleural effusion, ascites, additional volume of distribution appears, which can significantly increase the half-life of the drug. Therefore, in this category of patients, consideration should be given to reducing the dose of Methodject or discontinuing treatment with methotrexate.

Side effects

• from the digestive system: very often - loss of appetite, dyspepsia, nausea, stomatitis, increased level of transaminase activity; often - diarrhea, oral ulcers; sometimes - vomiting, cirrhosis, fatty degeneration and liver fibrosis, enteritis, hepatotoxicity (liver failure, acute hepatitis), a decrease in serum albumin levels; rarely - erosive and ulcerative lesions of the gastrointestinal tract; very rarely - vomiting mixed with blood, bleeding from the gastrointestinal tract (including hematemesis, melena); possibly pancreatitis;
• from the cardiovascular system: lowering blood pressure (BP), pericarditis, pericardial tamponade, pericardial effusion, thromboembolism (including arterial thrombosis, deep vein thrombosis, cerebral thrombosis, pulmonary embolism, thrombophlebitis, retinal vein thrombosis);
• from the hematopoietic system: often - anemia (including aplastic), neutropenia, leukopenia, thrombocytopenia; sometimes - pancytopenia; very rarely - a severe form of bone marrow suppression, agranulocytosis;
• infections: possible - impaired wound healing, nocardiosis, life-threatening cytomegalovirus (CMV) infections (including CMV pneumonia), opportunistic infections (including Pneumocystis pneumonia), cryptococcosis, sepsis (including fatal), histoplasmosis caused by Herpes simplex and Herpes zoster zoster infections (including disseminated forms);
• allergic reactions: all kinds of manifestations (including anaphylactic shock), fever, allergic vasculitis;
• from the nervous system: often - drowsiness, headache, fatigue; sometimes - dizziness, depression, feeling of confusion; very rarely - pain, paresthesia of the limbs, muscle weakness, impaired taste (metallic taste), convulsions, meningism, paralysis; possibly leukoencephalopathy;
• from the senses: rarely - conjunctivitis; very rarely - visual impairment (including transient blindness), retinopathy; possibly ringing in the ears;
• from the respiratory system: often - pneumonia or interstitial alveolitis, symptoms of potentially severe interstitial pneumonia (fever, dry unproductive cough and shortness of breath); sometimes pharyngitis; rarely - pulmonary pneumocystosis, pulmonary fibrosis, bronchial asthma, pulmonary insufficiency; possibly nosebleeds, pleural effusion;
• from the reproductive system: rarely - inflammation and ulceration of the vagina; very rarely - loss of sex drive, vaginal discharge, menstrual irregularities, impotence, oligospermia, infertility;
• from the urinary system: sometimes - painful urination, inflammation and ulcerative lesions of the bladder, hyperuricemia, hematuria, renal failure; rarely - oliguria, severe renal failure, azotemia, anuria;
• from the endocrine system: possibly diabetes mellitus;
• on the part of the musculoskeletal system: rarely - myalgia, arthralgia, osteoporosis, high risk of fractures, osteonecrosis; possibly - soft tissue necrosis;
• neoplasms: isolated cases - the occurrence of lymphomas (although research results do not confirm an increase in the incidence of lymphomas during therapy with methotrexate);
• from the side of metabolism: hypogammaglobulinemia, increased sweating; rarely - electrolyte imbalance;
• dermatological reactions: often - dermatitis, erythema, pruritus, exanthema; sometimes - baldness, photosensitivity, enlargement of rheumatic nodes, vasculitis, infections caused by Herpes zoster, skin herpetiform rash, acne, urticaria, ecchymosis; rarely - increased pigmentation; very rarely - acute paronychia, changes in nail pigmentation, Stevens-Johnson syndrome, furunculosis, telangiectasia, Lyell's syndrome; in the treatment of psoriasis - burning of the skin; rarely - the appearance of painful erosive plaques on the skin;
• local reactions: with intramuscular injection - burning sensation at the injection site, destruction of adipose tissue, formation of an aseptic abscess; very rarely, with subcutaneous administration - reactions at the injection site in the form of damage to surrounding tissues and the development of lipodystrophy, sterile abscess.

Overdose

Symptoms: the manifestation of the toxic effect of methotrexate mainly from the hematopoietic system.

Treatment: the introduction (if possible immediately) of a specific antidote - calcium folinate or sodium folinate.

During the first hour after a minor overdose of methotrexate, it is necessary to inject an intravenous or intramuscular dose of calcium folinate or sodium folinate, equal to or greater than the dose of the drug. The administration of sodium folinate or calcium folinate must be continued until the concentration of methotrexate in the blood serum is below 10 ^-7 mol / l.

In case of a significant overdose, hydration of the body and alkalinization of urine are required. This will prevent the precipitation of methotrexate and / or its metabolites in the renal tubules. The use of hemodialysis and peritoneal dialysis does not accelerate the excretion of methotrexate. There is information about the effectiveness of the use of a high-speed dialysis machine for intermittent hemodialysis.

special instructions

The severity and frequency of adverse effects of methotrexate treatment is not directly related to the dose or frequency of use. Therefore, all patients need to undergo regular medical examinations in a short period of time. The patient should inform the attending physician about the first signs of side effects.

It should be borne in mind that with the loss of fluid against the background of severe vomiting and diarrhea, the toxicity of methotrexate may increase.

Particularly careful monitoring of toxicity should be carried out in patients with ascites and pleural effusion, since with an additional volume of distribution, the rate of elimination of the drug from the body decreases. If necessary, the dose of Methodject should be reduced or treatment canceled. Peritoneal or pleural effusion should be drained before starting therapy.

When using Methodject, it is necessary to strictly follow the rules for handling cytotoxic drugs. Do not allow methotrexate to get on the skin and mucous membranes; in case of accidental contact, it should be immediately washed off with plenty of soap and water.

Patients with juvenile rheumatoid arthritis should be registered with a pediatric rheumatologist.

Before starting treatment, patients should be informed about the risk of developing severe adverse reactions (including fatal) and the necessary safety measures.

Treatment with Methodject should begin after a medical examination: a detailed clinical blood test, a biochemical blood test to determine the concentration of bilirubin, the activity of liver enzymes, and serum albumin. Thorough renal function tests, chest x-ray. In patients with tuberculosis and viral hepatitis, an additional diagnostic examination should be carried out to assess the activity of the disease.

In order to identify at an early stage signs of toxic effects or side effects and provide timely medical care, careful monitoring of the patient's condition is required during the treatment period. During the first six months of therapy, the examination should be carried out every month, then once every 2 months.

Monitoring the patient's condition includes the following diagnostic measures:

• examination of the oral mucosa and pharynx;
• detailed clinical blood test, including counting blood cells, determining the number of platelets;
• liver function tests, including liver biopsy in patients with psoriasis;
• functional tests and urinalysis to monitor kidney health;
• examination of the respiratory system.

It is necessary to take into account the influence of Methodjet on the immune system, a worsening of the response to vaccination and impairment of the results of immunological tests are possible. Particular care is required when treating patients with chronic infectious diseases (tuberculosis, Herpes zoster, hepatitis B or C) due to the risk of their exacerbation. During the period of treatment, immunization should be abandoned.

At low doses of methotrexate, the likelihood of malignant lymphomas increases; if they appear, treatment should be discontinued.

In case of manifestation of diarrhea and ulcerative stomatitis, it is necessary to temporarily cancel Methodject, since the risk of hemorrhagic enteritis and the patient's death on the background of interstitial perforation increases.

In patients with psoriasis, the Method should be used only after confirmation of the diagnosis by biopsy and / or after consultation with a dermatologist.

During the treatment period, it is necessary to avoid exposure to direct sunlight and ultraviolet radiation, especially patients with psoriasis should be careful.

Influence on the ability to drive vehicles and complex mechanisms

According to the instructions, Methodject can cause drowsiness and dizziness, so it is recommended to be careful when driving vehicles and mechanisms.

Application during pregnancy and lactation

The use of the Method is contraindicated during the period of gestation and breastfeeding.

Since methotrexate has teratogenic properties, conception is contraindicated in women during treatment, this can cause congenital malformations or death of the fetus.

If conception occurred during the use of the Method, it is necessary to conduct a thorough examination to assess the risk of the effect of treatment on the fetus.

Due to the risk of the genotoxic effect of the drug, women planning pregnancy should consult a geneticist before using it. Sperm preservation should be advised in male patients.

Before starting therapy, women of childbearing age should have a reliable pregnancy test to rule out pregnancy.

During the period of treatment with Methodject and at least 6 months after its cancellation, patients of childbearing age of both sexes need to use reliable methods of contraception.

Pediatric use

Due to the lack of information about the safety and effectiveness of treatment, the use of the Method in children under the age of 3 is contraindicated.

In the treatment of the polyarthritic form of juvenile chronic arthritis in children under the age of 16, only the IM administration of Methodject is indicated. A single dose of methotrexate is recommended to be determined at the rate of 10-15 mg per 1 m ² of body surface. In the absence of a sufficient clinical effect, the dose can be increased to 20 mg per 1 m ² per week.

With impaired renal function

In severe renal failure with CC less than 20 ml / min, the use of Methodject is contraindicated.

In renal failure with a CC of 20-50 ml / min, the usual dose should be halved.

For violations of liver function

In case of liver failure with a bilirubin concentration of more than 5 mg / dL (85.5 μmol / L), the use of methotrexate is contraindicated.

With great caution, Methodject should be used in case of severe liver dysfunction (including history), especially if they have arisen against the background of alcohol consumption.

Use in the elderly

Elderly patients may need to reduce the usual dose of Methodject due to a decrease in the body's reserve of folate and a decrease in liver or kidney function associated with age.

Drug interactions

With the simultaneous use of Methodject:

• alcohol with its regular use increases the likelihood of drug hepatotoxicity;
• leflunomide increases the risk of pancytopenia and hepatotoxicity;
• hepato- and hematotoxic (including retinoids, leflunomide, azathioprine, sulfasalazine) drugs increase the risk of hepato- and hematotoxicity of methotrexate. If necessary, concomitant therapy with these means, the patient should be carefully monitored;
• oral forms of non-absorbable antibacterial agents of a wide spectrum of action, chloramphenicol, tetracyclines cause suppression of the intestinal flora, suppress bacterial metabolism, therefore, they can affect the enterohepatic circulation of methotrexate;
• penicillins, glycopeptides, cephalothin, ciprofloxacin, sulfonamides can reduce the rate of excretion of methotrexate by the kidneys and cause an increase in its concentration in plasma and the risk of gastrointestinal and hematological toxicity;
• drugs that affect the bone marrow, including in the form of a side effect (including sulfonamides, sulfamethoxazole, chloramphenicol, trimethoprim, pyrimethamine) can cause severe inhibition of hematopoiesis;
• salicylates, tetracyclines, anti-inflammatory and hypoglycemic agents, sulfonamides, diuretics, diphenylhydantoin, diphenin, phenytoin, aminobenzoic acid, chloramphenicol can replace methotrexate bound to plasma proteins and lead to increased toxicity;
• pyrazolone drugs, weak organic acids, probenecid, and other non-steroidal anti-inflammatory drugs, even at low doses of methotrexate, can reduce the rate of its excretion and increase its hematological toxicity;
• sulfonamides, trimethoprim, sulfamethoxazole and other folate-deficient drugs increase the risk of methotrexate toxicity. Therefore, with a deficiency of folic acid, special care should be taken;
• vitamins, drugs containing folinic, folic acids and their derivatives reduce the effectiveness of the drug;
• cyclosporine, gold preparations, hydroxychloroquine, sulfasalazine, penicillamine, azathioprine and other antirheumatic drugs do not affect the toxic effect of methotrexate;
• sulfasalazine may increase the action and development of side effects of the drug;
• mercaptopurine increases its plasma concentration;
• omeprazole, pantoprazole and other proton pump inhibitors can reduce the excretion of methotrexate and 7-hydroxymethotrexate and cause the development of undesirable effects;
• theophylline can decrease its clearance, therefore it is necessary to control the level of theophylline in plasma;
• drinks containing caffeine and theophylline (coffee, caffeine-containing soft drinks, tea) - their use in large quantities should be excluded from the patient's diet.

Analogs

Metortrit and Methotrexate are analogs of Methodject.

Terms and conditions of storage

Keep out of the reach of children.

Store at temperatures up to 25 ° C in a dark place, do not freeze.

Shelf life is 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Methodject

Reviews of the Methodject are only positive. Taking the drug allows you to quickly stop joint pain. Use in rheumatoid arthritis not only relieves swelling and inflammation, but also allows patients to do without pain relievers. Users note the ease of use, requiring no assistance.

The disadvantages of all patients include the high cost of the drug, given the need for long-term use, and the difficulties in purchasing it in some regions.

Price for Methodject in pharmacies

The price for Methodject 10 mg / ml for 1 syringe of 1.5 ml can be 924-1189 rubles.

Methodject: prices in online pharmacies

Drug name Price Pharmacy

Methodject 50 mg / ml 10 mg solution for subcutaneous administration 0.2 ml 1 pc. 585 RUB Buy

Methodject 10 mg / ml injection 1 ml 1 pc. 695 RUB Buy

Methodject 50 mg / ml 15 mg solution for subcutaneous administration 0.3 ml 1 pc. RUB 835 Buy

Methodject 10 mg / ml injection solution 2 ml 1 pc. 859 r Buy

Methodject 50 mg / ml 12.5 mg solution for subcutaneous administration 0.25 ml 1 pc. 898 RUB Buy

Methodject 10 mg / ml solution for injection 1.5 ml 1 pc. RUB 910 Buy

Methodject 50 mg / ml 20 mg solution for subcutaneous administration 0.4 ml 1 pc. RUB 920 Buy

Methodject 50 mg / ml solution for subcutaneous administration 0.5 ml 1 pc. 1200 RUB Buy

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Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!