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 (omeprazole, etc) 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 change in the brand name for dabigatran from Pradax to Pradaxa
Anticoagulants more about bleeding with Pradaxa (dabigatran)
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Diabetes debate about whether diabetes patients who don't use insulin benefit from monitoring their blood glucose
Diabetes two new tablet strengths of Januvia (sitagliptin)
Gout rev up promotion of Uloric (febuxostat) for managing gout
Compounding new scrutiny of pharmacy compounding
Vaccines New recommendations will bring more focus on proper vaccine storage
Fibromyalgia Canadian guidelines will help improve fibromyalgia treatment
Interactions PPIs with methotrexate can lead to methotrexate toxicity
Practice we hope you'll enjoy the holiday letter from our staff