Severe intoxication with methotrexate possibly associated with concomitant use of proton pump inhibitors.
Anticancer Res
; 30(3): 963-5, 2010 Mar.
Article
em En
| MEDLINE
| ID: mdl-20393020
ABSTRACT
BACKGROUND:
Delayed elimination of methotrexate associated with serious side-effects has been attributed to the co-administration of benzimidazole proton pump inhibitors. PATIENTS ANDMETHODS:
We have retrospectively analyzed the causes of delayed methotrexate elimination in patients who had received the rescue agent glucarpidase to evaluate the potential implication of benzimidazoles.RESULTS:
Between 2002 and 2008, six patients (mean age 30 years; range 4-74 years) were treated with glucarpidase. Delayed elimination associated with impaired renal function occured after the first cycle except in 2 patients (2nd and 8th administration of high-dose methotrexate). The possible causes of delayed elimination identified were insufficient hydration (n=1) and drug-drug interactions (n=5). The potential drug-drug interactions included the co-administration of piperacillin/tazobactam (n=1) and proton pump inhibitors (omeprazole, n=3; esomeprazole, n=2). Impaired elimination of methotrexate was not observed either in the 3 patients who were treated further or during the previous cycles of the 2 pretreated patients in relation to the absence of co-prescription of proton pump inhibitors.CONCLUSION:
In line with the recent literature and given the prohibitive cost of glucarpidase, we have advocated the cessation of proton pump inhibitors administration during methotrexate treatment.
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Base de dados:
MEDLINE
Assunto principal:
Benzimidazóis
/
Protocolos de Quimioterapia Combinada Antineoplásica
/
Metotrexato
/
Inibidores da Bomba de Prótons
/
Antimetabólitos Antineoplásicos
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Child
/
Child, preschool
/
Humans
/
Middle aged
Idioma:
En
Revista:
Anticancer Res
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
França