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Related Experiment Videos

Potential interaction between methotrexate and omeprazole.

B Beorlegui1, A Aldaz, A Ortega

  • 1Pharmacy Department, University Hospital of Navarra, Pamplona, Spain.

The Annals of Pharmacotherapy
|September 12, 2000
PubMed
Summary

Concomitant use of omeprazole may delay high-dose methotrexate elimination, increasing toxicity risk. Healthcare providers should consider alternatives to omeprazole when prescribing methotrexate to ensure patient safety.

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Area of Science:

  • Pharmacology
  • Nephrology
  • Oncology

Background:

  • High-dose methotrexate (MTX) is a crucial chemotherapy agent.
  • Efficient renal excretion is vital for MTX safety and efficacy.
  • Proton pump inhibitors (PPIs) like omeprazole are commonly used for gastrointestinal protection.

Observation:

  • A case report details delayed MTX elimination in an 11-year-old boy receiving high-dose MTX and omeprazole.
  • The patient exhibited normal renal and liver function tests.
  • Discontinuation of omeprazole led to normalized MTX elimination in subsequent cycles.

Findings:

  • Omeprazole likely inhibited the renal H+/K+-ATPase pump, crucial for MTX tubular secretion.
  • This inhibition prolonged MTX elimination half-life, potentially leading to toxic MTX concentrations.

Related Experiment Videos

  • A probable drug interaction was identified using the Naranjo scale.

    • Implications:

    • Clinicians should consider omeprazole's potential to delay MTX elimination.
    • Alternative gastroprotective agents may be warranted during high-dose MTX therapy.
    • This interaction highlights the importance of reviewing concomitant medications in oncology patients.