Interaction Between Methotrexate and Non-Steroidal Anti-Inflammatory Drugs

Daly, Helena M.; Boyle, Joseph; Roberts, Clive J.; Scott, G. L.

doi:10.1016/s0140-6736(86)90910-4

Cited by 35 publications

(15 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although several pharmacokinetic abnormalities were recently encountered when low dose MTX and NSAIDs were associated for treatment of rheumatoid arthritis, there was no evidence of MTX-related toxicity (Ahern et al, 1988). This contrasted with earlier reports of fatal consequences after an association of low dose MTX plus NSAIDs (Singh et al, 1986;Daly et al, 1986). The present study clearly reveals the role of the MTX dose in the intensity of renal toxicity when combined with KP, with the lowest dose (50mgkg-') causing a lesser elevation in blood urea and creatinine.…”

Section: Discussioncontrasting

confidence: 87%

“…Since then, additional evidence of severe MTX toxicity has been reported when other NSAIDs are given with high dose MTX (Maiche, 1986) and even with low dose MTX (Singh et al, 1986;Daly et al, 1986). The fact that indomethacin (Maiche, 1986), naproxen (Singh et al, 1986) and azapropazone (Daly et al, 1986) have also been implicated supports our initial conclusions that the high risk of an association between MTX and KP should be extended to include other NSAIDs. A more recent study (Ahern et al, 1988) analysed the blood kinetics of low dose oral MTX in rheumatoid arthritis when NSAIDs were given conjointly.…”

supporting

confidence: 54%

See 1 more Smart Citation

Biochemical and pharmacological consequences of the interaction between methotrexate and ketoprofen in the rabbit

Perrin

Milano²,

Thyss³

et al. 1990

Br J Cancer

View full text Add to dashboard Cite

Summary Severe methotrexate (MTX) toxicity is a proven complication of associations of MTX and non-steroidal anti-inflammatory drugs (NSAIDs). This study investigated the interaction between MTX (50 or 100 mg kg-') and ketoprofen (KP) (3 mg kg-' day-', pretreatment for 8 days) in the rabbit. The drug association induced a reversible increase in blood urea and creatinine. The severity degree of 7-OH-MTX was prepared in our laboratory according to a method previously published (Jacobs et al., 1976). Briefly, MTX was incubated on rabbit liver homogenate purified in aldehyde oxidase activity. Total recovery was 15% (10 mg of 7-OH-MTX recovered for 75 mg of MTX incubated). The purity of the 7-OH-MTX (96%) was checked by HPLC and by UV and IR spectral analysis (Jacobs et al., 1976) (valency vibration of the -OH radical absorbing at 3,460 cm-').A KP preparation for i.v. injections (Profenid i.m. 100 mg Specia-Rhone Poulenc) was given at 3 mg kg-'.A calcium folinate preparation for i.v. injections (Lederfoline 50 mg, Lederle) was diluted five times by NaCI 0.9% and given at 0.5 mgkg-'.Cartridges for ultrafiltration were Centrifree (Amicon, Grace). Cartridges for solid extraction before HPLC analysis were SepPak C18 (Millipore Waters).A commercial RIA (1251)

show abstract

Section: Discussioncontrasting

confidence: 87%

supporting

confidence: 54%

Biochemical and pharmacological consequences of the interaction between methotrexate and ketoprofen in the rabbit

Perrin

Milano²,

Thyss³

et al. 1990

Br J Cancer

View full text Add to dashboard Cite

show abstract

“…Those patients with impaired renal function are at risk of increased toxicity. Other risk factors include the accumulation of third space fluids [50] and the simultaneous use of non-steroidal anti-inflammatory agents [51], reviewed in [52] and [53]. When given at high doses, i.e.…”

Section: Pharmacokinetic Profilementioning

confidence: 99%

From methotrexate to pemetrexed and beyond. A review of the pharmacodynamic and clinical properties of antifolates

2006

View full text Add to dashboard Cite

“…A further report of fatal bone marrow and renal toxicity after a single dose of MTX in a patient with RA receiving two NSAIDs2' highlights the potential risks from interaction between MTX and several NSAIDs. 22 The foregoing discussion centres around the concept that MP in RA is a reaction due to cumulative toxicity. Several authors, however, have suggested that MP represents a drug hypersensitivity reaction in view of the wide range of prior dosage of MTX and the frequent accompaniment of eosinophilia in the peripheral blood and sometimes in the lung biopsy specimens.…”

Section: Discussionmentioning

confidence: 99%

Life threatening acute pneumonitis during low dose methotrexate treatment for rheumatoid arthritis: a case report and review of the literature.

Ridley

Wolfe

Mathews

1988

Annals of the Rheumatic Diseases

View full text Add to dashboard Cite

SUMMARY A patient is described with definite rheumatoid arthritis (RA) who developed life threatening acute pneumonitis after receiving a total dose of only 12-5 mg methotrexate (MTX). This complication has been previously described, but this is probably the lowest reported dose before development of pneumonitis in a patient with RA. The possible significance of this case is discussed in the light of recent reports suggesting an increased susceptibility of patients with RA to the pulmonary toxicity of MTX.

show abstract

Interaction Between Methotrexate and Non-Steroidal Anti-Inflammatory Drugs

Cited by 35 publications

References 1 publication

Biochemical and pharmacological consequences of the interaction between methotrexate and ketoprofen in the rabbit

Biochemical and pharmacological consequences of the interaction between methotrexate and ketoprofen in the rabbit

From methotrexate to pemetrexed and beyond. A review of the pharmacodynamic and clinical properties of antifolates

Life threatening acute pneumonitis during low dose methotrexate treatment for rheumatoid arthritis: a case report and review of the literature.

Contact Info

Product

Resources

About