title: [Proton Pump Inhibitor and High-dose Methotrexate: Two Cases Reports].
abstract: Methotrexate (MTX) is a cytotoxic agent prescribed at high dose in treatment of malignancy. Association of MTX to proton pump inhibitor (PPI) is not recommended if doses are more than 20 mg per weeks and only to take into account for smaller doses. Review relate some cases of delayed elimination of methotrexate in patients taking PPI, which increase risk of toxic event. However, currently there is no status quo on interaction between PPI and MTX according to available data. We report two clinical cases illustrating one more time a toxic event to MTX in presence of PPI. In absence of risk/benefit ratio set correctly, an assessment of appropriateness of PPI prescription before MTX therapy can limit an iatrogenic risk.
authors.affiliation: Service Pharmacie, Hôpital Pierre Oudot, CH Bourgoin-Jallieu, Bourgoin-Jallieu, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Evrard
authors.affiliation: Service Pharmacie, Hôpital Pierre Oudot, CH Bourgoin-Jallieu, Bourgoin-Jallieu, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Farnier
authors.affiliation: Centre Régional de Pharmacovigilance de Lyon, Lyon, France.
authors.forename: Corine
authors.initials: C
authors.lastname: Carcel
authors.affiliation: Service Médecine Interne et Onco-Hématologie, Hôpital Pierre Oudot, CH Bourgoin-Jallieu, Bourgoin-Jallieu, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Lachenal
authors.affiliation: Centre Régional de Pharmacovigilance de Lyon, Lyon, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Vial
authors.affiliation: Service Pharmacie, Hôpital Pierre Oudot, CH Bourgoin-Jallieu, Bourgoin-Jallieu, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Pont
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000517:prevention & control / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D003520:Cyclophosphamide / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage; D003875:Drug Eruptions / Q000209:etiology*; D004347:Drug Interactions; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D052016:Mucositis / Q000139:chemically induced*; D009853:Omeprazole / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D010039:Otorhinolaryngologic Neoplasms / Q000188:drug therapy; D010198:Pancytopenia / Q000139:chemically induced*; D000077402:Pantoprazole; D019338:Polypharmacy; D011241:Prednisone / Q000008:administration & dosage; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D000069283:Rituximab / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D000077402:Pantoprazole; D009853:Omeprazole; D011241:Prednisone; D008727:Methotrexate