Practice
Low-dose methotrexate toxicity
Kevin Pivovarov and Jonathan S. Zipursky
CMAJ April 15, 2019 191 (15) E423; DOI: https://doi.org/10.1503/cmaj.181054
Kevin Pivovarov
Department of Medicine (Pivovarov, Zipursky), University of Toronto; Division of Internal Medicine (Pivovarov), Mount Sinai Hospital; Division of Clinical Pharmacology and Toxicology (Zipursky), Sunnybrook Health Sciences Centre, Toronto, Ont.
MDJonathan S. Zipursky
Department of Medicine (Pivovarov, Zipursky), University of Toronto; Division of Internal Medicine (Pivovarov), Mount Sinai Hospital; Division of Clinical Pharmacology and Toxicology (Zipursky), Sunnybrook Health Sciences Centre, Toronto, Ont.
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Low-dose methotrexate toxicity
Kevin Pivovarov, Jonathan S. Zipursky
CMAJ Apr 2019, 191 (15) E423; DOI: 10.1503/cmaj.181054
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- Article
- Methotrexate is used at low doses for the treatment of autoimmune and inflammatory disorders
- Complete blood count, liver and renal function should be monitored during treatment
- Toxicity can cause bone marrow, hepatic and pulmonary disorders
- Decreased clearance, drug–drug interactions and dosing errors are risk factors for toxicity
- Folic acid or folinic acid (leucovorin) is used to prevent and treat toxicity
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