Interference of high-dose methotrexate in the metabolism of valproate?
A case of tonic-clonic seizure was observed in a child with acute lymphoblastic leukemia a few hours after a 24-hour infusion of high-dose methotrexate (MTX; 5 g/m2). Because of former epileptic symptoms, the child had been treated with valproic acid for several months. During this and the following high-dose MTX infusion, an acute decline of the serum valproate concentration to about 25% of the pre-MTX value was observed. The pathogenesis of the acute decline of serum valproate concentration is discussed.
Schrøder
H
H
Department of Pediatrics, University Hospital of Aarhus, Denmark.
Ostergaard
J R
JR
D002648:Child; D004347:Drug Interactions; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000494:pharmacology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D014635:Valproic Acid / Q000378:metabolism*
D014635:Valproic Acid; D008727:Methotrexate