Is methotrexate nephrotoxic? : Dose-dependency, comorbidities and comedication.
Summary of "Is methotrexate nephrotoxic? : Dose-dependency, comorbidities and comedication."
Methotrexate (MTX) in low-doses is an important component of anti-inflammatory therapy of rheumatoid arthritis and other inflammatory joint diseases. In contrast to high-dose administration of MTX in oncology, which can lead to direct tubulus toxicity and subsequent renal failure, renal side-effects are a rare exception for low-dose MTX. The biggest problem under low-dose MTX is that an already limited renal function due to comorbidities or an increasing, sometimes clinically insufficiently monitored renal insufficiency due to comedications, such as non-steroidal antirheumatics (NSAR) and antibiotics, leads to a reduced excretion of MTX and therefore to an accumulation in serum. This is primarily accompanied by gastrointestinal mucositis and bone marrow depression. For this reason low-dose MTX should never be administered once the glomerular filtration rate (GFR) is less than <30 ml/min and only 50% of the original dosage should be administered if the GFR is between 30 and 60 ml/min.
Division of Nephrology, University of Virginia Health System, 800133, 22908, Charlottesville, USA, firstname.lastname@example.org.
This article was published in the following journal.
Name: Zeitschrift fur Rheumatologie
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21735288
- DOI: http://dx.doi.org/10.1007/s00393-011-0830-6
N5-Formyltetrahydrofolate (leucovorin) counteracted methotrexate toxicity in suspension cultures of Nicotiana tabacum var. Xanthi. Methotrexate at 50 nM inhibited growth of the tobacco cell cultures b...
High-dose methotrexate therapy (HD-MTX) has been well established for the treatment of childhood acute lymphoblastic leukemia (ALL). The aims of this study were to investigate whether clinical and pha...
To report a case of delayed methotrexate (MTX) elimination while receiving concomitant levetiracetam.
A 50-year-old male with psoriatic arthritis since 20 years and on methotrexate since 12 years developed an asymptomatic black patch over his right sole of two years duration. On examination, patient h...
The purpose of this study is to investigate the clinical efficacy of high-dose methotrexate consolidation therapy for adult patients with BCR-ABL-negative ALL.
RATIONALE: Drugs used in chemotherapy, such as methotrexate, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. PURPO...
The purpose of this clinical study is to compare the efficacy and safety of three concentrations of topical methotrexate for the treatment of fingernail psoriasis.
The purpose of this study is to investigate whether the administration of Voraxaze reduces exposure to leucovorin and its active metabolite to below the level achieved in patients who have...
The purpose of this study is to compare two preoperative chemotherapy regimens based on high-dose methotrexate courses given alternately either with doxorubicin or with etoposide-ifosfamid...
Medical and Biotech [MESH] Definitions
The dose amount of poisonous or toxic substance or dose of ionizing radiation required to kill 50% of the tested population.
The highest dose of a biologically active agent given during a chronic study that will not reduce longevity from effects other than carcinogenicity. (from Lewis Dictionary of Toxicology, 1st ed)
Administration of the total dose of radiation (RADIATION DOSAGE) in parts, at timed intervals.
Radiotherapy where there is improved dose homogeneity within the tumor and reduced dosage to uninvolved structures. The precise shaping of dose distribution is achieved via the use of computer-controlled multileaf collimators.
A specific immune response elicited by a specific dose of an immunologically active substance or cell in an organism, tissue, or cell.