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Disposition of high‐dose methotrexate in an obese cancer patient
Author(s) -
Fleming Ronald A.,
Eldridge Russell M.,
Johnson Christopher E.,
Stewart Clinton F.
Publication year - 1991
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19910915)68:6<1247::aid-cncr2820680611>3.0.co;2-o
Subject(s) - medicine , methotrexate , pharmacokinetics , volume of distribution , renal function , obesity , disposition , pharmacology , distribution (mathematics) , cancer , urology , psychology , social psychology , mathematical analysis , mathematics
The disposition of many drugs in obesity is altered, although little is known of the effect of obesity on the pharmacokinetics of anti‐cancer drugs. In this report the authors describe the pharmacokinetics of high‐dose methotrexate in an obese woman (184% ideal body weight) with osteosarcoma. For this patient, both the volume of distribution at steady‐state (0.398 I/kg) and systemic clearance (0.0956 I/h/kg) of methotrexate were increased compared with values observed in adult patients with osteosarcoma. The terminal elimination half‐life (9.29 hours) of methotrexate was similar to other reported values in adult patients, thus indicating that increases in methotrexate volume of distribution and clearance may offset each other in obesity. Based on the experience gained from this patient, the authors suggest that renal function and methotrexate serum concentrations should be monitored in obese patients receiving high‐dose methotrexate with leucovorin rescue.

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