Methotrexate is a medication used to treat various conditions, including cancer, rheumatoid arthritis, and psoriasis. However, its use in older patients can pose certain risks.

According to Drug Patent Watch [1], methotrexate can cause a variety of side effects, including gastrointestinal issues, liver toxicity, and bone marrow suppression. These side effects can be particularly concerning for older patients, who may already have compromised organ function. Additionally, methotrexate can interact with other medications, which can further increase the risk of adverse effects.

A study published in the Journal of the American Geriatrics Society [2] found that methotrexate use in older patients with rheumatoid arthritis was associated with an increased risk of infection, particularly respiratory infections. The study also noted that older patients may be more susceptible to methotrexate toxicity due to age-related changes in organ function.

Another study published in the British Journal of Clinical Pharmacology [3] similarly found that older patients with rheumatoid arthritis who were treated with methotrexate had a higher risk of adverse effects, including gastrointestinal issues and liver toxicity. The study suggested that careful monitoring of older patients receiving methotrexate is necessary to minimize the risk of these adverse effects.

In conclusion, while methotrexate can be an effective treatment for certain conditions, it can pose risks for older patients, including organ toxicity, infection, and adverse effects. Careful monitoring and consideration of the patient's overall health status and medication regimen are necessary to minimize these risks.

Sources:
[1] https://www.drugpatentwatch.com/p/tradename/METHOTREXATE
[2] https://pubmed.ncbi.nlm.nih.gov/8972245/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1741826/