Pharmacy Times – April 2012

 

Drug Interactions: Insights and Observations

 

Methotrexate and Proton Pump Inhibitors

 

John R. Horn, PharmD, FCCP and Philip D. Hansten, PharmD

 

 

References

 

1. Reid T, et al. Impact of omeprazole on the plasma clearance of methotrexate. Cancer Chemother. Pharmacol. 1993;33:82–84.

2. Whelan J, et al. Omeprazole does not alter plasma methotrexate. Cancer Chemother. Pharmacol. 1999;33:88–89.

3. Beorlegui B, et al. Potential interaction between methotrexate and omeprazole. Ann. Pharmacother. 2000;34:1024–1027.

4. Tršger U, et al. Severe myalgia from an interaction between treatments with pantoprazole and methotrexate. Br. Med. J. 2002;324:1497.

5. Bauters TGM, et al. Interaction between methotrexate and omeprazole in an adolescent with leukemia: a case report. Pharm. World Sci. 2008;30:316–318.

6. Vakily M et al. Coadministration of lansoprazole and naproxen does not affect the pharmacokinetic profile of methotrexate in adult patient with rheumatoid arthritis. J Clin Pharmacol. 2005:45:1179-1186.

7. Joerger M, et al. Determinants of the elimination of methotrexate and 7-hydroxy-methotrexate following high-dose infusional therapy to cancer patients. Br. J. Clin. Pharmacol. 2005;62:71–80.

8. Suzuki K, et al. Co-administration of proton pump inhibitors delays elimination of plasma methotrexate in high-dose methotrexate therapy. Br. J. Clin. Pharmacol. 2009;67:44–49.

9. Santucci R, et al. Delayed elimination of methotrexate associated with co-administration of proton pump inhibitors. Anticancer Res. 2010;30:3807–3810.

10. Santucci R, et al. Severe intoxication with methotrexate possibly associated with concomitant use of proton pump inhibitors. Anticancer Res. 2010;30:963–966.

11. Breedveld P, et al. Mechanism of the pharmacokinetic interaction between methotrexate and benzimidazoles: potential role for breast cancer resistance protein in clinical drug– drug interactions. Cancer Res. 2004;64:804–5811.

12. Mikkelsen TS et al. PharmGKB summary: methotrexate pathway. Pharmacogenet Genomics. 2011;21:679-686.