Can food influence the absorption of methotrexate in children with acute lymphoblastic leukaemia?

Serum levels of methotrexate (MTX) were measured in 10 children with acute lymphoblastic leukaemia over a 4 hour period after oral administration. The drug was given to each child on three occasions: first, with no food, then with a milky meal, and finally with a citrus meal. Peak serum MTX levels were significantly reduced by the milky meal and both meals delayed drug absorption in most children. The area under the absorption curve was also significantly reduced by the milky meal. Thus, for maximum serum levels, MTX should not be given with food, and if patients are to be grouped on the basis of their MTX absorption profile this should be determined under standard conditions in relation to meals.