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Suspicion of drug-drug interaction between high-dose methotrexate and proton pump inhibitors: a case report - should the practice be changed?
- Source :
-
Chemotherapy [Chemotherapy] 2011; Vol. 57 (3), pp. 225-9. Date of Electronic Publication: 2011 May 18. - Publication Year :
- 2011
-
Abstract
- We report a case of a potential drug-drug interaction in a woman treated by a first injection of high-dose methotrexate for a T-lymphoblastic lymphoma. Valaciclovir, fluoxetine and pantoprazole were given concomitantly. A methotrexate overdosage was shown at 36 h after infusion associated with a severe renal failure. Alkaline hyperhydration, folinic acid and carboxypeptidase G2 were given. Prescription analyses by pharmacists and literature research have permitted us to suggest that a drug-drug interaction between methotrexate and proton pump inhibitors (PPI) was responsible for this renal failure. Several mechanisms of interaction were suggested and might be related to the inhibition of renal methotrexate transporters by PPI, an increase in the methotrexate efflux to the blood by an upregulation of multidrug resistance protein 3 by PPI or genetic polymorphisms. This case shows that pharmacists can help physicians to optimize patient treatment: they consensually decided on the systematic discontinuation of PPI or a switch to ranitidine when patients were treated by high-dose methotrexate.<br /> (Copyright © 2011 S. Karger AG, Basel.)
- Subjects :
- Acyclovir analogs & derivatives
Acyclovir therapeutic use
Antimetabolites, Antineoplastic metabolism
Antimetabolites, Antineoplastic therapeutic use
Antiviral Agents therapeutic use
Drug Interactions
Female
Fluoxetine therapeutic use
Humans
Methotrexate metabolism
Methotrexate therapeutic use
Middle Aged
Pantoprazole
Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy
Renal Insufficiency etiology
Valacyclovir
Valine analogs & derivatives
Valine therapeutic use
2-Pyridinylmethylsulfinylbenzimidazoles therapeutic use
Antimetabolites, Antineoplastic adverse effects
Methotrexate adverse effects
Proton Pump Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1421-9794
- Volume :
- 57
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Chemotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 21597286
- Full Text :
- https://doi.org/10.1159/000327372