Jul 14, 2005

Methotrexate pulmonary toxicity

Expert Opinion on Drug Safety
Omar LateefRobert A Balk


Methotrexate is a commonly prescribed antineoplastic and immune modulating compound that has gained wide acceptance in the management of rheumatoid arthritis, psoriasis, sarcoidosis and a number of neoplastic disorders. Although generally considered safe and easy to use, methotrexate has been associated with a number of adverse reactions. Pulmonary toxicity has been well-described and may take a variety of forms. Pulmonary infiltrates are the most commonly encountered form of methotrexate pulmonary toxicity and these infiltrates resemble hypersensitivity lung disease. This discussion focuses primarily on low-dose methotrexate pulmonary toxicity and will discuss the diagnosis using clinical, pulmonary function, radiographical and pathological manifestations. Suggestions for clinical monitoring to detect adverse effects are given. In addition, management of pulmonary toxicity through discontinuation of the methotrexate, support and possibly the administration of corticosteroids is discussed.

  • References31
  • Citations42

Mentioned in this Paper

Antineoplastic Agents
Infiltrate of Lung
Antimetabolites, Antineoplastic
Extrinsic Allergic Alveolitis
Corticosteroids, topical for treatment of hemorrhoids and anal fissures
Adverse Effects
Rheumatoid Arthritis
Adrenal Cortex Hormones

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