| Suspected Methotrexate Toxicity From Omeprazole: A Case Review of Carboxypeptidase G2 Use in a Methotrexate-Experienced Patient With Methotrexate Toxicity and a Review of the Literature. | |
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MedLine Citation:
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PMID: 22550162 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We report a case of methotrexate toxicity potentially induced by a drug interaction between methotrexate and omeprazole in a 25-year-old man with osteosarcoma. The patient was placed on omeprazole after his first cycle of high-dose methotrexate for stress ulcer prophylaxis, and it was discontinued before the start of the first day of the patient's second round of high-dose methotrexate. The 24-hour methotrexate level was elevated and he continued to have sustained levels for 18 days. Side effects due to elevated serum methotrexate included seizures, mucositis, acute renal failure, and thrombocytopenia. Aggressive hydration, urinary alkalinization, and leucovorin were continued during the period of elevated methotrexate levels, with the patient receiving a course of hemodialysis and a dose of carboxypeptidase G2.( )The patient's symptoms resolved, and his renal function returned to baseline within 2 months. The patient was able to receive future courses of chemotherapy without methotrexate. Although use of the Naranjo adverse reaction probability scale indicated a probable relationship (score of 6) between the patient's development of methotrexate toxicity and omeprazole use, we believe this was a drug-drug interaction case consistent with previous reports in the literature. |
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Authors:
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Ali McBride; Scott J Antonia; Eric B Haura; Dawn Goetz |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-5-1 |
Journal Detail:
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Title: Journal of pharmacy practice Volume: - ISSN: 1531-1937 ISO Abbreviation: - Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-5-2 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8900945 Medline TA: J Pharm Pract Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Pharmacy, The Ohio State University, Columbus, OH. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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