Methotrexate Toxicity

Overview

Methotrexate is a chemotherapeutic drug utilized for the treatment of various illnesses such as cancer, rheumatoid arthritis, systemic lupus erythematosus, and psoriasis. Methotrexate toxicity occurs when there is an overdose of the medication.

Signs and Symptoms

Alopecia, Photosensitivity, Rash, Fatigue, Fever with chills, Gastrointestinal bleed, Reddening of skin, Gingivitis, Nausea, Vomiting, Diarrhea, Hypotension, Headache, Seizures, Encephalopathy

Common Causes

Accidental overdose of methotrexate tablets by the patient or physician, Increased patient susceptibility during the treatment , Intentional self-administration

Risk Factors

Underlying acute renal failure or hypoalbuminemia, Alcohol intake, Use of other medications that may interact with methotrexate such as trimethoprim and non-steroidal antiinflammatory drugs and salicylates

Investigation Techniques

Full blood count, Urine analysis, Urine FEME, Kidney function test, Liver function test, Serial methotrexate concentrations, urine output

Treatment and Prevention

Gastric lavage with activated charcoal, Antidote (Folinic acid) administration, Adequate hydration and urinary alkalinization, Hemodialysis