Toxic reaction to methotrexate in a patient receiving penicillin and furosemide: a possible interaction

Ceftazidime and cefepime antagonize 5-fluorouracil’s effect in colon cancer cells

“…Considering the increase in the awareness about toxicities relating to the concomitant presence of anticancer drugs and antibiotics, the number of reported data is still insufficient. Most studies report on the increase in the toxicity, due to interactions at the PK level, of methotrexate (MTX), an anti-folate agent effective against different types of tumors [ 17 , 18 , 37 , 38 ], when in combination with different classes of antibiotics such as fluoroquinolones [ 17 ], ß-lactams (i.e. : penicillin and cephalosporin) [ 39 , 40 ], and sulfonamide [ 34 ].…”

The use of liquid chromatography-tandem mass spectrometry for therapeutic drug monitoring of antibiotics in cancer patients

“…Delay in MTX elimination has been also documented in children concomitantly receiving ciprofloxacin [46]. Competition in renal clearance between MTX and penicillin antibiotics has been also reported three decades ago whereby the simultaneous presence of MTX and phenoxymethylpenicillin (penicillin V) resulted in transient toxicity in a case study of a patient with prostate cancer [47]. Other antibiotics such as amoxicillin, piperacillin, oxacillin and pristinamycin have similarly resulted in delayed clearance of MTX [48,49].…”

“…Recently, toxicities resulting from a combination therapy of antibiotic and antineoplastic agents have been also documented [45]. Most of the reports are on the effect of the co-administration of antibiotics along with methotrexate (MTX), an anti-folate agent effective against different types of tumors such as lymphoma, osteosarcoma and bladder [45][46][47]. The observed toxicity was not limited to the combination of MTX with one class of antibiotics but covered different classes such as fluoroquinolones, β-lactams (i.e.…”

Methotrexate Toxicity During Treatment of Chronic Plaque Psoriasis: A Case Report and Review of the Literature

“…As with other methotrexate toxicity, skin ulceration has been described in the context of an adverse drug interaction when new medications are added to an existing methotrexate regimen [ 62 ]. Examples include; trimethoprim, amiodarone [ 63 ], furosemide [ 63 ], penicillin [ 63 ], and NSAIDs [ 51 ].…”