Oral effects of low-dose methotrexate treatment.
Methotrexate is used increasingly in low-dose regimes for a variety of conditions, particularly rheumatoid arthritis. While certain adverse effects of low-dose methotrexate have been described in detail, oral complications have received little attention. This article includes a summary of the uses and pharmacology of low-dose methotrexate and the mechanisms that lead to general and oral toxicity. The literature relevant to potential oral adverse effects is discussed and 7 illustrative cases are presented. The oral effects noted range from nonhealing ulcers to lymphoma-like lesions. Dental practitioners should be aware of the possible oral effects of low-dose methotrexate that have so far been largely unrecognized.
Kalantzis
Athanasios
A
Department of Oral Pathology, GKT Dental Institute, Guy's Tower, King's College London, Guy's Hospital, London, UK. thanasiskalantzis@hotmail.com
Marshman
Zoe
Z
Falconer
Denis T
DT
Morgan
Peter R
PR
Odell
Edward W
EW
D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D001853:Bone Marrow / Q000187:drug effects; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D005260:Female; D005493:Folic Acid Antagonists / Q000009:adverse effects / Q000378:metabolism; D041981:Gastrointestinal Tract / Q000187:drug effects; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects; D019226:Oral Ulcer / Q000139:chemically induced* / Q000473:pathology; D012189:Retrospective Studies; D013280:Stomatitis / Q000139:chemically induced* / Q000473:pathology
D018501:Antirheumatic Agents; D005493:Folic Acid Antagonists; D008727:Methotrexate