Authors' recommendations: Methotrexate is an antifolate drug that is used alone or in combination with other drugs to treat a variety of cancers. Methotrexate is administered over a wide dose range, which can be as low as 20 mg/m2 (milligrams per square meter) for maintenance therapy or 1000 mg/m2 when used as highdose therapy. Acute renal dysfunction is a life-threatening complication that is caused by the precipitation of methotrexate, and its metabolites, in the renal tubules. Renal dysfunction delays the renal clearance of methotrexate, leading to elevated plasma concentrations of the drug and the potential for additional methotrexate toxicities including myelosuppression, mucositis, hepatitis, and dermatitis. Patients receiving high-dose methotrexate therapy are treated with aggressive hydration and alkalinization to improve the solubility of methotrexate, and leucovorin, a folate that can counteract the effects of methotrexate. With this regimen, in combination with close patient monitoring, the incidence of methotrexate nephrotoxicity decreases from about 10% to approximately 1% to 2%. Despite the reduced incidence of methotrexate-induced toxicity, cases of severe and fatal nephrotoxicity still occur.

Project Status: Completed

Year Published: 2012

URL for published report: http://www.hayesinc.com/hayes/crd/?crd=13503

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: HAYES, Inc.

Contact Address: 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218

Contact Name: saleinfo@hayesinc.com

Contact Email: saleinfo@hayesinc.com

Copyright: 2011 Winifred S. Hayes, Inc