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Given that (i) Mtx acts by inhibiting the enzyme dihydrofolatereductase (DHFRase) which generates the essential coenzyme tetrahydrofolic acid (THFA) fromdihydrofolic acid (DHFA) needed for one carbon transfer reactions, (ii) Mtx binds to the catalyticsite of DHFRase with an affinity 50,000 times greater than the natural substrate DHFA, and that(iii) two forms of folate viz. Arterioscler Thromb Vasc Biol, 30 (8): 1665–1671.de Lau, L.M.
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No adverse events and no differ-ences in the outcomes were observed.