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Severe intoxication with methotrexate possibly associated with concomitant use of proton pump inhibitors.
Santucci, Raoul; Levêque, Dominique; Kemmel, Véronique; Lutz, Patrick; Gérout, Anne-Cécile; N'guyen, Aurélia; Lescoute, Aurélie; Schneider, Francis; Bergerat, Jean-Pierre; Herbrecht, Raoul.
Afiliación
  • Santucci R; Pharmacy, Hôpital Hautepierre, avenue Molière, 67000 Strasbourg, France.
Anticancer Res ; 30(3): 963-5, 2010 Mar.
Article en En | MEDLINE | ID: mdl-20393020
BACKGROUND: Delayed elimination of methotrexate associated with serious side-effects has been attributed to the co-administration of benzimidazole proton pump inhibitors. PATIENTS AND METHODS: 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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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Bencimidazoles / Protocolos de Quimioterapia Combinada Antineoplásica / Metotrexato / Inhibidores de la Bomba de Protones / Antimetabolitos Antineoplásicos Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Child / Child, preschool / Humans / Middle aged Idioma: En Revista: Anticancer Res Año: 2010 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Grecia
Buscar en Google
Añadir a Mi BVS
Imprimir
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PubMed Links

Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Bencimidazoles / Protocolos de Quimioterapia Combinada Antineoplásica / Metotrexato / Inhibidores de la Bomba de Protones / Antimetabolitos Antineoplásicos Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Child / Child, preschool / Humans / Middle aged Idioma: En Revista: Anticancer Res Año: 2010 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Grecia