Abstract：OBJECTIVE To investigate the characteristics of adverse drug reaction (ADR) of methotrexate by analyzing clinical cases, and to provide reference for rational use of drugs. METHODS A total of 109 cases of adverse drug reactions related to methotrexate reported in our hospital from January 2010 to June 2021 were retrospectively analyzed. RESULTS Among the 109 ADRs, there were 64 males and 45 females, ranging from 2 to 77 years old, with an average age of 20.26±16.45 years old. There were 98 cases of intravenous infusion, 6 cases of oral administration, 5 cases of intrathecal injection and intravenous infusion. The main clinical manifestations of ADR were liver injury, skin damage,kidney injury, bone marrow suppression and mucosal injury. There were 22 cases of severe ADR, 16 of which had delayed excretion. CONCLUSION We should be paid attention to the safety of methotrexate, take active measures to prevent and correctly deal with ADR caused by methotrexate, and reduce the risk of serious ADR.
CUO C, HUANG G, LIN F, et al. Expert consensus on high-dose methotrexate calcium folinate rescue therapy for malignant tumors [J]. Chin J Clin Oncol(中国肿瘤临床), 2019, 46(15):761-766.
[2]
LAN Y, LIU S H, LU Z, et al. Analysis of medical record in a patient with high-dose methotrexate induced severe adverse reaction [J]. Drug Eval(药品评价), 2015, 12(22):37-39.
[3]
HOWARD SC, MCCORMICK J, PUI CH, et al. Preventing and managing toxicities of high-dose methotrexate[J].Oncologist, 2016, 21(12):1471-1482.
[4]
LI S, YAN H H, ZHANG P, et al. Multiple organ dysfunction in children induced by delayed elimination of high-dose methotrexate injection[J]. Chin J Pharmacov(中国药物警戒), 2020, 17(6):377-380.
[5]
MAZAUD C, FARDET L. Relative risk of and determinants for adverse events ofmethotrexate prescribed at a low dose: a systematic review and meta－analysis of randomized placebo－controlled trials[ J].Br J Dermatol, 2017, 177(4): 978-986.
[6]
ZHOU Y Z, MEI D, HAN X, et al. Inflencing factors of serum methotrexate concentratiom-analysis of 1050 serum methotrexate concentratiom monitoring [J]. Clin Med J(临床药物治疗杂志), 2017, 15(5):22-26.
[7]
WUZ, DING T L, QIU X Y, et al. Clinical pharmacists' pharmaceutical care of a patient with renal injury caused by high dose methotrexate [J]. Chin J Clin Pharm(中国临床药学杂志), 2020, 29(5):385-388.
[8]
YI Z G, LIU H Y, DING Z, et al. Clinical common adverse reactions of methotrexate and their countermeasures [J]. Chin Rem Clin(中国药物与临床), 2014, 14(11):1529-1530.
[9]
XU W Q, ZHANG L Y, CHEN X Y, et al. Serum creatinine and creatinine clearance for predicting plasma methotrexate concentrations after high-dose methotrexate chemotherapy for the treatment for childhood lymphoblastic malignancies[J]. Cancer Chemother Pharmacol, 2014, 73(1):79-86.
[10]
YAN N, MA J J, XIA F. Serious acute kidney injury induced by high-dose methotrexate chemotherapyin one patient [J]. Chin J New Drugs Clin Rem(中国新药与临床杂志), 2017, 36(3):173-175.
[11]
PANG L, LIU L M, ZHAO L M. Research progress in influence factors of excretion delay of high-dose methotrexate[J]. Chin Pharm J((中国药学杂志), 2013, 48(22):1892-1896.
[12]
ZHANG C Y, REN X L, FENG W Y, et al. The effect of MTHFR and ABCB1 genetic polymorphism on serioustoxicity and elimination delay of high dose methotrexate[J]. Chin New Drugs J(中国新药杂志), 2019, 28(1):117-119.
2022, Vol. 57 
