Methotrexate and trimethoprim-sulphamethoxazole--a potentially hazardous combination.
A 74-year-old woman had been treated with methotrexate over 2 years for rheumatoid arthritis. She was admitted to the hospital because of non-healing leg ulcers. After being treated with trimethoprim-sulphamethoxazole for a urinary-tract infection, she developed severe pancytopenia, followed by pneumonia and septic shock. The patient died shortly after. Concomitant treatment with methotrexate and sulphonamides should be strongly discouraged.
Groenendal
H
H
Department of Dermatology, Saint Anna Hospital, Oss, The Netherlands.
Rampen
F H
FH
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000188:drug therapy; D008727:Methotrexate / Q000009:adverse effects*; D010198:Pancytopenia / Q000139:chemically induced*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000188:drug therapy
D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D008727:Methotrexate