title: Adverse drug reactions caused by methotrexate in Saudi population.
abstract: OBJECTIVE
  The aim of this study is to document adverse drug reactions (ARDs) of methotrexate (MTX) in Saudi patients.
  
  
  METHODS
  Cross sectional study of adult patients on MTX, attending rheumatology drug monitoring clinics in a university hospital, over a period of 24 weeks. Adverse drug reactions were sought by patient interview, files review and laboratory abnormalities.
  
  
  RESULTS
  Data collected included patients' demographics, diagnoses, co-morbidities, MTX dose and duration, other medications, laboratory abnormalities and adverse reactions, their severity, preventability, and outcome. Out of a total of 593 patients screened, 186 (31.4%) using MTX were interviewed. Most of the patients were female (88.5%). Adverse drug reactions (ADRs) were detected in 61 patients (32.8%). Patients with ADRs took a mean dose of 12.9 mg (2.5-22.5 mg). Ten ADRs (16.4% of total reactions) were preventable; they ranged between severe, moderate and mild. The most common ADRs were gastrointestinal (GI) (52.5%), followed by anemia (8.2%) and chest tightness (6.6%). The duration of the reaction ranged from few hours to 4 years.
  
  
  CONCLUSIONS
  In conclusion our patients with adverse reactions were younger, took less medications and had less co-morbidities. Our results were different from those published in the literature relating MTX toxicity.
authors: Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
authors: Haya M
authors: HM
authors: Al-Malaq
authors: Hussein F
authors: HF
authors: Al-Arfaj
authors: Abdurhman S
authors: AS
authors: Al-Arfaj
keywords: Adverse drug reactions; Methotrexate; Saudi Arabia
references: J Rheumatol. 2008 Apr;35(4):572-9
references: 18381794
references: Treat Guidel Med Lett. 2009 May;7(81):37-46; quiz 47-8
references: 19390497
references: Clin Pharmacol Ther. 1981 Aug;30(2):239-45
references: 7249508
references: Ann Rheum Dis. 2009 Jul;68(7):1081-2
references: 19525405
references: Ann Pharmacother. 2002 Sep;36(9):1331-6
references: 12196047
references: QJM. 2001 Jun;94(6):309-19
references: 11391029
references: Br J Dermatol. 2009 Mar;160(3):622-8
references: 18945303
references: Saudi Med J. 2008 Aug;29(8):1145-50
references: 18690308
references: Br J Dermatol. 2009 Jun;160(6):1345-6
references: 19416263
references: J Clin Pharm Ther. 1997 Feb;22(1):61-6
references: 9292405
references: Ann Rheum Dis. 2009 Jul;68(7):1094-9
references: 19033290
references: Clin Pharmacol Ther. 1998 Oct;64(4):450-61
references: 9797802
references: Ann Rheum Dis. 2009 Jul;68(7):1086-93
references: 19033291
references: Ann Rheum Dis. 2009 Jul;68(7):1105-12
references: 19054823
references: World Health Organ Tech Rep Ser. 1969;425:5-24
references: 4981079
references: Arthritis Rheum. 2008 Jun 15;59(6):762-84
references: 18512708
references: Arthritis Rheum. 2006 May;54(5):1366-77
references: 16645965
references: Rheumatology (Oxford). 2000 Dec;39(12):1374-82
references: 11136881
references: Am Fam Physician. 2000 Oct 1;62(7):1607-12, 1614
references: 11037077