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The terminal half-life reported for methotrexate is approximately 3 to 10 hours for patients receiving treatment for psoriasis, or rheumatoid arthritis or low dose antineoplastic therapy less than 30 mg m 2 .

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Methotrexate has been shown to decrease endogenous tetrahydrobiopterin bh4 concentrations by inhibiting the enzyme dihydropteridine reductase; a similar reaction could be expected in patients receiving sapropterin.

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