Effect of hydration on plasma-methotrexate levels
Romolo, J.L.; Goldberg, N.H.; Hande, K.R.; Rosenberg, S.A.
Cancer Treatment Reports 61(7): 1393-1396
1977
ISSN/ISBN: 0361-5960 PMID: 303939 Document Number: 110929
The effect of the volume and rate of i.v. fluid replacement on the disappearance of MTX from the systemic circulation was studied in 7 patients with osteogenic sarcoma. No difference was noted in plasma MTX levels at various times following the infusion of 250 mg/kg of MTX in patients receiving i.v. fluids at the rate of 75 ml/h for 48 h compared to those receiving 200 ml/h for 60 h. Myelosuppression, impairment of renal function, or compromise of hepatic function was not seen in any patient, regardless of the amount of i.v. fluids administered when urinary pH was kept > 7.0. It appears that the utilization of vigorous hydration, designed to prevent toxicity during the administration of high dose MTX, does not lead to more rapid clearance of MTX or subsequent decreased therapeutic effectiveness. Vigorous hydration should continue to be utilized in high dose MTX therapy because it does not appear to alter MTX pharmacokinetics.