Is methotrexate nephrotoxic? : Dose-dependency, comorbidities and comedication.

06:00 EDT 8th July 2011 | BioPortfolio

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,

Journal Details

This article was published in the following journal.

Name: Zeitschrift fur Rheumatologie
ISSN: 1435-1250


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