A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Trexall Overdose, Contraindications and Information - Methotrexate
Trexall Overdose, Contraindications and Information - Methotrexate
OVERDOSE
Leucovorin is indicated to diminish the toxicity
and counteract the
effect of inadvertently administered overdosages of methotrexate.
Leucovorin administration should begin as promptly as possible.
As the time
interval between methotrexate
administration
and leucovorin initiation increases, the effectiveness
of leucovorin in counteracting toxicity
decreases. Monitoring of the serum
methotrexate concentration
is essential in determining
the optimal dose and duration
of treatment with
leucovorin.
In cases of massive overdosage, hydration and urinary alkalinization
may be necessary to prevent the precipitation of methotrexate and/or its
metabolites in the renal tubules.
Generally speaking, neither hemodialysis nor peritoneal dialysis have
been shown to
improve methotrexate elimination. However, effective
clearance of methotrexate has been reported with acute, intermittent
hemodialysis using a high-flux dialyzer. (Wall, SM et al: AM J Kidney Dis
28(6):846-854, 1996).
CONTRAINDICATIONS
Methotrexate can cause
fetal death
or teratogenic effects
when administered to a pregnant
woman. Methotrexate is contraindicated in pregnant
women with psoriasis
or rheumatoid arthritis
and should be used in the treatment of neoplastic diseases only
when the potential
benefit outweighs the
risk to the fetus. Women of childbearing
potential should not
be started on methotrexate until pregnancy
is excluded and should be fully counseled on the serious risk
to the fetus (see PRECAUTIONS)
should they become pregnant
while undergoing treatment. Pregnancy should be avoided if either
partner is receiving methotrexate; during and for a minimum
of three months after therapy
for male patients, and
during and for at least one ovulatory
cycle after therapy
for female patients.
(See WARNINGS.)
Because of the potential
for serious adverse reactions from methotrexate in breast
fed infants, it is contraindicated in nursing
mothers.
Patients with psoriasis
or rheumatoid arthritis
with alcoholism,
alcoholic liver disease
or other chronic liver
disease should not receive
methotrexate.
Patients with psoriasis
or rheumatoid arthritis
who have overt or laboratory evidence of immunodeficiency
syndromes should not receive methotrexate.
Patients with psoriasis
or rheumatoid arthritis
who have preexisting blood dyscrasias, such
as bone marrow
hypoplasia, leukopenia,
thrombocytopenia or significant
anemia, should not receive
methotrexate.
Patients with a known hypersensitivity
to methotrexate
should not receive the drug.
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