Methotrexate toxicity: Clinical features, manifestation, management and comparison between treatment modalities.

Tejas Rane; Sanjay Thorat; Akshay Kale

Volume : VII, Issue : IX, September - 2018

Methotrexate toxicity: Clinical features, manifestation, management and comparison between treatment modalities.

Tejas Rane, Sanjay Thorat, Akshay Kale

Abstract :

Methotrexate is a potential chemotherapeutic drug.It is used in the treatment of a variety of illnesses including cancer, rheumatoid arthritis, systemic lupus erythematous, and psoriasis. Methotrexate toxicity is one of the common toxicity noticed in routine practice. The most common cause of acute methotrexate toxity is an accidental overdose of the tablets by patients. Here we describe three cases,first case: A 65 year old patient diagnosedas arthritis on methotrexate therapy since 6 months,self medicated as qd for one week, she was treated withInjLeucovorin (folinic acid); second case: A 50 yr old female diagnosed with discoid lupus erythematous on Methotrexate therapy,administered tab. Methotrexateqd for 5–6 days, she was treated with InjFilgrastim; third case: A 80 year old male patient diagnosed as arthritis on methotrexate therapy 2.5 mg 4 times a week, but due to prescription error patient had 10 mg tablets 4 times a week for two weeks. He was treated with oral Folinic acid 5 mg qd for 3 days andafterwardswas treated with InjFilgrastim for 4 days. Conclusion: Both Leucovorin and Filgrastim showed effective mode of treatment for Methotrexate toxicity. But Leucovorin is better among both due to its good safety profile, lesser side effects, is cheaper, and is pharmacological antagonist of methotexate. So Leucovorin should be admistered as primary treatment of choice for Methotrexatetoxicity.