Cola beverage and delayed elimination of methotrexate

Santucci, Raoul; Levêque, Dominique; Herbrecht, Raoul

doi:10.1111/j.1365-2125.2010.03744.x

Cited by 23 publications

(13 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The present case developed toxicity despite the rescue, the probable factors to be considered are high dosage with respect to her body weight, not recognising the minor side effects initially and not advocating the double dose of leucovorin inspite of the advice and may be due to hypersensitivity to methotrexate because of MTHFR 2 mutations 11. The other reasons for methotrexate toxicity reported in the literature include genetic polymorphism in the folate metabolic pathway delaying the clearance of methotrexate,12 delay in renal excretion due to consumption of cola beverages,13 the state of hydration, concomitant drugs taken such as trimethoprim and sulphamethoxazole, and proton pump inhibitor like dilantin 14. Methotrexate clearance was moderately reduced in patients with the MTHFR 677TT.…”

Section: Discussionmentioning

confidence: 99%

Life-threatening complications following multidose methotrexate for medical management of ectopic pregnancy

Dasari

Sagili

2012

BMJ Case Reports

View full text Add to dashboard Cite

SummaryA 25-year-old primigravida was diagnosed to be suffering from unruptured ectopic pregnancy. The serum β-human chorionic gonadotropin levels were 2851 mIU/l and the ectopic gestational sac was 2.7×2.7 cm without any fetal pole. It was decided to manage her by expectant therapy. But she received medical therapy with multidose methotrexate because of misinterpretation of expectant therapy as medical therapy. She suffered from methotrexate toxicity, which manifested as high-grade fever, vomiting, melena, oral ulcerations, pneumonitis, subconjunctival haemorrhages and skin pigmentation. She developed severe third space fluid collection and shock, which was mistaken for rupture ectopic gestation. Her haematological picture showed severe neutropaenia and thrombocytopaenia which confirmed the clinical picture to be due to methotrexate toxicity. She also developed septicaemia and candidal infection secondary to immunosuppression. She was managed in intensive care unit with ventilatory support, high-dose leucovorin and injection filgastrim. She responded well to the therapy with dramatic recovery in 4 days. BACKGROUND

show abstract

Section: Discussionmentioning

confidence: 99%

Life-threatening complications following multidose methotrexate for medical management of ectopic pregnancy

Dasari

Sagili

2012

BMJ Case Reports

View full text Add to dashboard Cite

show abstract

“…Despite supportive measures, methotrexate nephrotoxicity continues to be reported, varying from 1.8% in patients with osteosarcoma to 9.1% in hematologic malignancy . Recently, consumption of cola beverages has been implicated as a factor lowering urinary pH, delaying elimination of methotrexate, and inducing acute renal failure …”

Section: Introductionmentioning

confidence: 99%

Delayed methotrexate elimination: Incidence, interaction with antacid drugs, and clinical consequences?

Ranchon

Vantard

Hénin

et al. 2017

Hematological Oncology

View full text Add to dashboard Cite

The aim of this retrospective cohort study was to investigate the incidence of delayed methotrexate elimination in patients treated with high-dose methotrexate (≥1 g/m ) for haematological malignancy and to identify the impact of interacting drugs, especially proton-pump inhibitors (PPIs) and ranitidine. All patients treated with high-dose methotrexate over a 6 year period in the haematology department of the Lyon Sud University Hospital (Hospices Civils de Lyon, France) were included. Potential risk factors for delayed methotrexate elimination were tested in a generalized linear model by univariate analysis: patient age, gender, methotrexate dose, administration of PPI or ranitidine, and concomitant nephrotoxic drugs. A total of 412 cycles of methotrexate were administered to 179 patients. Proton-pump inhibitors were co-administered with methotrexate in 127 cycles and ranitidine in 192 cycles. Ninety-three cycles included no antacid drugs. A total of 918 plasma methotrexate assays were performed. Methotrexate concentrations were checked at 24 hours in 92% of cycles. Delayed methotrexate elimination was observed in 20.9% of cycles. A total of 63 cycles with delayed methotrexate elimination were only identified on plasma methotrexate measures at 72 hours: ie, plasma methotrexate was in the normal range at 24 and 48 hour post injection. Use of PPI/ranitidine or no antacid drugs did not increase risk of delayed elimination, with respectively delayed methotrexate elimination in 20.5%, 21.9%, and 19.4% of cycles (P = .89). Impaired baseline creatinine clearance showed significant association in univariate analysis. Fifteen patients showed grade 1 acute kidney injury, 1 grade 2, 2 grade 3, and none grade 4. For half of these cases, delayed methotrexate elimination was observed and the 2 grade 3 events appeared in patients treated with PPIs. This retrospective study suggests that there is no association between concomitant use of proton-pump inhibitors (pantoprazole and esomeprazole) or ranitidine and delayed methotrexate elimination.

show abstract

“…A correlation between SDs and incidence of certain diseases, such as obesity, diabetes mellitus and cardiovascular disease has been confirmed (6)(7)(8). In addition, it has been shown that Coca-Cola consumption delayed elimination of methotrexate and, therefore, is a predisposing factor for acute renal failure (9).…”

Section: Introductionmentioning

confidence: 86%

Carbonated soft drinks alter hepatic cytochrome P450 isoform expression in Wistar rats

2016

View full text Add to dashboard Cite

Abstract.The aim of the current study was to examine the effects of chronic consumption of soft drinks (SDs) on hepatic oxidative stress and cytochrome P450 enzymes (CYPs) expression in the livers of Wistar rats. For 3 consecutive months, the rats had free access to three different soft drinks, Coca-Cola, Pepsi-Cola and 7-UP. The rats were subsequently compared with control group rats that had consumed water. Blood and hepatic tissue samples were assayed for the changes in antioxidants, liver function biomarkers and hepatic gene expression for different isoforms of hepatic CYP. The results indicated that SD consumption (SDC) decreased serum antioxidant levels and increased malondialdehyde secretion, and increased liver biomarkers (glutamate pyruvate transaminase and glutamate oxaloacetate). SD induced alterations in mRNA expression of hepatic antioxidants and cytochrome isoforms. The expression of peroxidase, catalase, CYP1A2, CYP3A2 and CYP2C11 in the liver were upregulated following SDC. By contrast, CYP2B1 was downregulated after 3 months of SDC in liver tissue samples. Thus, the present findings indicate that SDs induced oxidative stress in the liver of Wistar rats and for the first time, to the best of our knowledge, indicate that SDC disrupts hepatic CYP enzymes that may affect drug metabolism. Therefore, drug-dosing programs should be carefully designed to take these novel findings into consideration for the treatment of diseases.

show abstract

Cola beverage and delayed elimination of methotrexate

Cited by 23 publications

References 4 publications

Life-threatening complications following multidose methotrexate for medical management of ectopic pregnancy

Life-threatening complications following multidose methotrexate for medical management of ectopic pregnancy

Delayed methotrexate elimination: Incidence, interaction with antacid drugs, and clinical consequences?

Carbonated soft drinks alter hepatic cytochrome P450 isoform expression in Wistar rats

Contact Info

Product

Resources

About