Skip to main content
Log in

Pharmacokinetics of high-dose methotrexate treatment in children

  • Originals
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Summary

The pharmacokinetics of intravenous high-dose methotrexate were studied in two groups of children being treated for malignant diseases, mostly acute lymphatic leukemia. The peak serum level of methotrexate of 2.32·10−5 mol/l was found in children given 500 mg methotrexate/m2 by a 24 h infusion, and another group given 2790 mg/m2 during a 6 h infusion had serum levels as high as 2.16·10−4 mol/l. The decay of serum concentration of methotrexate after completion of the infusion followed a diphasic curve, with an initial serum half-life of 4.8 h, followed by a second half-life of 34.4 h at distribution equilibrium. The apparent volume of distribution was 56.8 litres/m2. Significant levels of methotrexate were found in cerebrospinal fluid, but penetration into cerebrospinal fluid was slow. Urinary excretion of methotrexate was considerable. Four to five days after commencement of the infusion, urinary concentrations of methotrexate still exceeded the serum levels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bratlid, D., Bergan, T.: Displacement of albumin-bound antimicrobial agents by bilirubin. Pharmacology14, 464–472 (1976)

    Google Scholar 

  2. Dahl, S. G.: Dosering av medikamenter ut fra deres distribusjons volum og biologiske halveringstid. Tidsskr. Nor. Laegeforen.94, 1208–1211 (1974)

    Google Scholar 

  3. Djerassi, I., Rominger, C. J., Kim, J. S., et al.: Phase I study of high doses of methotrexate with citrovorum factor in patient with lung cancer. Cancer30, 22–30 (1972)

    Google Scholar 

  4. Frei, E., Jaffe, N., Pitman, S.: Limitations of the methotrexate and citrovorum-factor treatment. N. Engl. J. Med.292, 107–108 (1975)

    Google Scholar 

  5. Goldie, J. H., Price, L. A., Harrap, K. R.: Methotrexate toxicity: correlation with duration of administration, plasma levels, dose and excretion pattern. Eur. J. Cancer8, 409–414 (1972)

    Google Scholar 

  6. Huffman, D. H., Wan, S. H., Azarnoff, D. L., Hoogstraten, B.: Pharmacokinetics of methotrexate. Clin. Pharmacol. Ther.14, 572–579 (1973)

    Google Scholar 

  7. Jaffe, N., Frei, E., Traggis, D., Bishop, Y.: Adjuvant methotrexate and citrovorum-factor treatment of osteogenic sarcoma. N. Engl. J. Med.291, 994–997 (1974)

    Google Scholar 

  8. Kinkade, J. M., Vogler, W. R., Dayton, P. G.: Plasma levels of methotrexate in cancer patients as studied by an improved spectrophotofluorometric method. Biochem. Med.10, 337–350 (1974)

    Google Scholar 

  9. Lewitt, M., Mosher, M. B., DeConti, R. C., et al.: Improved therapeutic index of methotrexate with leukovorin rescue. Cancer Res.32, 1729–1734 (1973)

    Google Scholar 

  10. Pinedo, H. M., Zaharko, D. S., Bull, J. M., Chabner, B. A.: The reversal of methotrexate cytotoxicity to mouse bone marrow cells by leukovorin and nucleosides. Cancer Res.36, 4418–4424 (1976)

    Google Scholar 

  11. Salasoo, S., Irving, M. G., Freedman, A.: Methotrexate megadose followed by folate resque. II. Clearance patterns in patients receiving sequential megadose infusions. Med. J. Aust.1, 826–828 (1976)

    Google Scholar 

  12. Shapiro, W. R., Young, D. F., Mehta, B. M.: Methotrexate: Distribution in cerebrospinal fluid after intreavenous, ventricular and lumbar injections. N. Engl. J. Med.293, 161–166 (1975)

    Google Scholar 

  13. Stoller, R. G., Jacobs, S. A., Drake, J. C., Lutz, R. J., Chabner, B. A.: Pharmacokinetics of high-dose methotrexate (NSU-740). Cancer Chemother. Rep.6, 19–24 (1975)

    Google Scholar 

  14. Wang, J. J., Freeman, A. I., Sinks, L. F.: Treatment of acute lymphocytic leukemia by high-dose intravenous methotrexat Cancer Res.36, 1441–1444 (1976)

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bratlid, D., Moe, P.J. Pharmacokinetics of high-dose methotrexate treatment in children. Eur J Clin Pharmacol 14, 143–147 (1978). https://doi.org/10.1007/BF00607446

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00607446

Key words

Navigation