title: Pharmacokinetic interaction between methotrexate and chloral hydrate.
abstract: We report the case of a drug interaction between methotrexate (MTX) and chloral hydrate (CH) observed in a child treated for acute leukemia. Significantly slower MTX clearance and increased MTX exposure occurred on the first three courses of a high-dose chemotherapy when co-administered with CH despite normal renal function, adequate hydration, and alkalinization. Mean MTX area under the curve associated with CH administration was 1,134 µmol hours/L, compared to 608 µmol hours/L after discontinuation of CH. This interaction possibly resulted from a competition between anionic CH metabolites and MTX for renal tubular excretion.
authors.affiliation: Division of Clinical Pharmacology, Biomedicine, Department of Laboratories, CHUV, Lausanne 1011, Switzerland.
authors.forename: Kim
authors.initials: K
authors.lastname: Dao
authors.forename: Anton
authors.initials: A
authors.lastname: Ivanyuk
authors.forename: Thierry
authors.initials: T
authors.lastname: Buclin
authors.forename: Maja
authors.initials: M
authors.lastname: Beck-Popovic
authors.forename: Manuel
authors.initials: M
authors.lastname: Diezi
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D002675:Child, Preschool; D002697:Chloral Hydrate / Q000009:adverse effects* / Q000493:pharmacokinetics*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000493:pharmacokinetics*; D007278:Injections, Spinal; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics*; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D006993:Hypnotics and Sedatives; D002697:Chloral Hydrate; D008727:Methotrexate