Pancytopenia and Methotrexate with Trimethoprim- Sulfamethoxazole
Authors: M. E. Jeurissen
Journal: Annals of Internal Medicine (1989)

Letters and Corrections1 August 1989Pancytopenia and Methotrexate with Trimethoprim- SulfamethoxazoleM. E. Jeurissen, MD, A.M. Boerbooms, MD, PhD, L.B. van de Putte, MD, PhDM. E. Jeurissen, MD, A.M. Boerbooms, MD, PhD, L.B. van de Putte, MD, PhDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-3-261_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: Kozarek and colleagues (1) found a dramatic clinical improvement in patients treated with methotrexate who had refractory Crohn colitis and an incomplete remission of chronic ulcerative colitis. Of 21 patients, 14 were also receiving either sulfasalazine or metronidazole (exact number of patients not mentioned).The risk of bone marrow suppression is increased when other antifolate drugs (derivatives of sulfonamides, trimethoprim) are used simultaneously with methotrexate. Besides additive folate antagonism, other pharmacologic mechanisms, such as competition with tubular secretion and displacement from albumin binding sites, play an important role in interactions of sulfonamides and methotrexate. Moreover, it was...References1. KozarekPattersonGelfandBotomanBallWilsh RDMVTK. Methotrexate induces clinical and histological remission in patients with refractory inflammatory bowel disease. Ann Intern Med. 1989;110:353-6. LinkGoogle Scholar2. HalsteadGhandiTamura CGT. Sulphasalazine inhibits the absorption of folates in ulcerative colitis. N Engl J Med. 1981;305:1513-7. CrossrefMedlineGoogle Scholar3. MaricicDavisGall MME. Megaloblastic pancytopenia in a patient receiving concurrent methotrexate and trimethoprim-sulfamethoxazole treatment. Arthritis Rheum. 1986;29:133-5. CrossrefMedlineGoogle Scholar4. ThomasGutterman ML. Methotrexate toxicity in a patient receiving trimethoprim-sulfamethoxazole. J Rheum. 1986;13:440-1. MedlineGoogle Scholar5. MacKinnonStarkebaumWillkens SGR. Pancytopenia associated with low pulse methotrexate in the treatment of rheumatoid arthritis. Arthritis Rheum. 1985;15:119-26. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: M. E. Jeurissen, MD; A.M. Boerbooms, MD, PhD; L.B. van de Putte, MD, PhDAffiliations: University Hospital Nijmegen 6525 GA Nijmegen The Netherlands PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA Survey of the Adverse Effects and Influence of Concomitant Drugs for Methotrexate Intrathecal AdministrationEffect of ceftriaxone and cefepime on high-dose methotrexate clearanceMethotrexateTrimethoprim and co-trimoxazoleCytostatic and cytotoxic drugsDisease-Modifying Antirheumatic Drug Use in Older Rheumatoid Arthritis PatientsMethotrexate Drug Interactions in the Treatment of Rheumatoid Arthritis: A Systematic ReviewCanadian Recommendations for Use of Methotrexate in Patients with Rheumatoid ArthritisDRUGS USED IN CANCER CHEMOTHERAPYANTIBACTERIAL DRUGSGLUCOCORTICOIDS AND DISEASE – MODIFYING ANTIRHEUMATIC DRUGSRole and place of methotrexate in vasculitis managementMethotrexate: Understanding the risk in psoriasis patientsClinically Significant Drug–Drug Interactions Between Oral Anticancer Agents and Nonanticancer Agents: Profiling and Comparison of Two Drug CompendiaMethotrexate-induced pancytopenia associated with co-prescription of penicillin and trimethoprimMethotrexateA guide to clinically relevant drug interactions in oncologyPharmacokinetics and Pharmacodynamics of Methotrexate in Non-Neoplastic DiseasesSevere Pancytopenia Associated with Low-Dose Methotrexate Therapy for Rheumatoid ArthritisMethotrexate as an alternative to classic immunosuppressive therapiesHigh-Dose Methotrexate–Doxycycline InteractionToxicity Profile of Methotrexate in Rheumatoid ArthritisMethotrexate in rheumatoid arthritis: An updatewith focus on mechanisms involved in toxicityPHARMACOLOGY AND PHARMACOKINETICS OF METHOTREXATE IN RHEUMATIC DISEASEMETHOTREXATE USE IN SYSTEMIC VASCULITISTHE REMARKABLE SPECTRUM OF METHOTREXATE TOXICITIESPancytopenia secondary to methotrexate therapy in rheumatoid arthritisTreatment of psoriasis with cytotoxic drugsNeutropenia due to low‐dose methotrexate therapy for psoriasis and rheumatoid arthritis may be fatalMiscellaneous antibacterial and antiviral drugs 1 August 1989Volume 111, Issue 3Page: 261-261KeywordsAlbuminsBone marrowColitisDrugsFolic acidMethotrexateSulfonamideUlcerative colitis ePublished: 1 December 2008 Issue Published: 1 August 1989 PDF downloadLoading ...