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Folex PFS (methotrexate) Disease Interactions

There are 5 disease interactions with Folex PFS (methotrexate):

Major

Antineoplastics (Includes Folex PFS) ↔ Infections

Severe Potential Hazard, Moderate plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Doxil (doxorubicin liposomal)." Sequis Pharmaceuticals Inc, Menlo Park, CA.
  3. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  4. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  5. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  6. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  7. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.
  8. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  9. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb, Princeton, NJ.
  10. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  11. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
  12. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  13. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
  14. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
  15. "Product Information. Taxotere (docetaxel)." Rhone-Poulenc Rorer, Collegeville, PA.
  16. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn, Kalamazoo, MI.
  17. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
  18. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb, Princeton, NJ.
  19. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  20. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
  21. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  22. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, NJ.
  23. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
  24. "Product Information. Tabloid (thioguanine)." Glaxo Wellcome, Research Triangle Park, NC.
  25. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  26. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation, Eatontown, NJ.
  27. "Product Information. Nipent (pentostatin)." Parke-Davis, Morris Plains, NJ.
  28. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  29. "Product Information. DTIC-Dome (dacarbazine)." Bayer, West Haven, CT.
  30. "Product Information. Thiotepa (thiotepa)." Lederle Laboratories, Wayne, NJ.
  31. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
View all 31 references
Major

Methotrexate (Includes Folex PFS) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease, Alcoholism

The use of methotrexate is contraindicated as treatment for psoriasis or rheumatoid arthritis in patients with alcoholism, alcoholic liver disease or other chronic liver diseases. Methotrexate causes hepatotoxicity, fibrosis and cirrhosis, usually after long-term therapy. Fibrosis and cirrhosis may not be preceded by symptoms or abnormal liver function tests. If methotrexate is used, patients should be instructed to immediately report any signs or symptoms suggestive of hepatic dysfunction such as jaundice, dark urine, right upper quadrant pain, or anorexia. Persistent liver function test abnormalities and/or depression of serum albumin may require evaluation, including a liver biopsy.

References

  1. "Product Information. Methotrexate and Methotrexate LPF (methotrexate)." Lederle Laboratories, Wayne, NJ.
  2. "Product Information. Rheumatrex (methotrexate)." Lederle Laboratories, Wayne, NJ.
Major

Methotrexate (Includes Folex PFS) ↔ Myelosuppression

Severe Potential Hazard, Moderate plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral, Bone Marrow Depression/Low Blood Counts, Anemia

Methotrexate can induce myelosuppression causing leukopenia, thrombocytopenia, neutropenia, pancytopenia and anemia. Therapy with methotrexate is contraindicated as treatment of psoriasis in patients with bone marrow suppression or preexisting blood dyscrasias. Methotrexate should be discontinued immediately in patients with psoriasis or rheumatoid arthritis if there is a significant fall in blood cell counts. If need outweighs risk, therapy with methotrexate should be administered cautiously in patients with malignancy and hematopoietic impairment. Additionally, methotrexate should be used with extreme caution in patients with active infection, and it is usually contraindicated in patients with overt or laboratory evidence of immunodeficiency syndromes. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression or infection such as fever, sore throat, or bleeding. Clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Rheumatrex (methotrexate)." Lederle Laboratories, Wayne, NJ.
  2. "Product Information. Methotrexate and Methotrexate LPF (methotrexate)." Lederle Laboratories, Wayne, NJ.
Major

Methotrexate (Includes Folex PFS) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction, Pleural Effusion

Methotrexate is primarily eliminated by the kidney via glomerular filtration and active secretion. Clearance rates for methotrexate vary and at higher doses are generally decreased due to saturation of renal tubular reabsorption. Renal impairment or third space effusion (ascites, pleural effusions), decrease elimination and increase methotrexate serum concentrations. Therapy with methotrexate should be administered cautiously and at reduced dosages in patients with compromised renal function. Administration of leucovorin reduces toxicity from high dose methotrexate regimens or delayed elimination. Clinical monitoring of renal function is recommended.

References

  1. "Product Information. Methotrexate and Methotrexate LPF (methotrexate)." Lederle Laboratories, Wayne, NJ.
  2. "Product Information. Rheumatrex (methotrexate)." Lederle Laboratories, Wayne, NJ.
Major

Methotrexate (Includes Folex PFS) ↔ Stomatitis

Severe Potential Hazard, High plausibility

Applies to: Inflammatory Bowel Disease, Peptic Ulcer, Diarrhea

Methotrexate induces stomatitis within the oral mucosa and gastrointestinal tract. Therapy with methotrexate should be administered with extreme caution in patients with peptic ulcer disease or ulcerative colitis. If vomiting, diarrhea or ulcerative stomatitis occur, treatment should be discontinued until recovery to avoid the risk of hemorraghic enteritis or intestinal perforation which could be fatal.

References

  1. "Product Information. Rheumatrex (methotrexate)." Lederle Laboratories, Wayne, NJ.
  2. "Product Information. Methotrexate and Methotrexate LPF (methotrexate)." Lederle Laboratories, Wayne, NJ.

Folex PFS (methotrexate) drug Interactions

There are 835 drug interactions with Folex PFS (methotrexate)

Folex PFS (methotrexate) alcohol/food Interactions

There are 3 alcohol/food interactions with Folex PFS (methotrexate)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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