- Contraindications:
- Septra (Bone marrow toxicity)
- Probenecid (blocks tubular secretion of methotrexate)
- GI Toxicity:
- GI intolerance is the most common adverse reaction;
- anorexia, nausea, vomiting, diarrhea, and even unexplained wt loss
- Bone Marrow Toxicity:
- may occur and is usually associated w/ following
- risk factors:
- renal insufficiency
- folic acid depletion
- use of concomitant trimethoprim/sulfamethoxazole;
- supplemental folic acid (1 mg/day) may reduce the risk of hematologic toxicity without interfering with efficacy;
- Toxic Effects on the Liver
- manifested by fever, abdominal pain, diarrhea, & maculopapular skin rash;
- look for elevated LFT's