PPIs with methotrexate can lead to methotrexate toxicity

December 2012

You'll see warnings that using PPIs with methotrexate can lead to methotrexate toxicity.

PPIs seem to decrease the renal clearance of methotrexate and its active metabolites...and increase their serum levels.

The greatest risk is with high-dose methotrexate infusions for cancer...but problems might also occur with lower doses.

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Table of Contents

Cardiology whether ALL patients with coronary artery disease should take a beta-blocker
Anticoagulants Xarelto (rivaroxaban) will be used to TREAT venous thromboembolism
Anticoagulants more about bleeding with Pradaxa (dabigatran)
Gastroenterology Linzess (lin-ZESS, linaclotide) for irritable bowel syndrome with constipation or chronic constipation in adults
Corticosteroids Rayos, a new delayed-release prednisone designed for evening dosing
Vaccines Prevnar 13 vaccine will be used in certain ADULTS
Vaccines New CDC guidelines will bring more focus on proper vaccine storage
Diabetes debate about whether diabetes patients who don't use insulin benefit from monitoring their blood glucose
Respiratory & Allergy Tudorza Pressair (TU-door-za, aclidinium), a new inhaled bronchodilator for COPD
Gout rev up promotion of Uloric (febuxostat) for managing gout
Compounding new oversight of pharmacy compounding
Interactions PPIs with methotrexate can lead to methotrexate toxicity
Practice enjoy the holiday letter from our staff