Methotrexate (MTX; alphamethopterin; amethopterin; methylaminopterin; CL-14377; NCIC04671; WR19039; NCI-C04671) is an FDA approved antineoplastic and immunosuppressant drug that belongs to the antimetabolite and antifolate class of drugs. It acts by inhibiting the metabolism of folic acid in activated peripheral T cells. Specifically, methotrexate binds to and inhibits the enzyme dihydrofolate reductase, resulting in inhibition of purine nucleotide and thymidylate synthesis and, subsequently, inhibition of DNA and RNA syntheses. Methotrexate (Amethopterin) is the disease-modifying antirheumatic drug (DMARD) of first choice for the treatment of RA in most countries worldwide. Methotrexate is an antineoplastic agent used to fight a number of different cancers, such as acute lymphoblastic leukemia and solid cancers.