How can you prevent methotrexate toxicity?

How can you prevent methotrexate toxicity?

To prevent high-dose methotrexate toxicity, the urine should be alkalinized via administration of sodium bicarbonate. “We keep the urine pH >7.5 because methotrexate and its metabolites are less soluble at lower urine pH’s,” Mandock reported.

How do you prevent mucositis?


  1. brush your teeth with a soft toothbrush at least twice a day.
  2. gently floss once a day if you can.
  3. rinse your mouth with warm water (or water mixed with a bit of salt) several times a day.
  4. suck on crushed ice or ice lollies.
  5. eat soft, moist foods, like soup, jelly or soft fruit, or try adding gravy or sauces to meals.

How is methotrexate mucositis treated?

The treatment for methotrexate-induced mucositis required hospitalization in case 1, methotrexate discontinuation in both cases and oral folic acid supplementation in case 2. Results: In both cases, the mucositis healed and no relapse was observed.

How can I prevent mucositis during chemo?

Allopurinol mouthwashes 4 to 6 times per day have been evaluated as prophylaxis against mucositis resulting specifically from the action of 5- fluorouracil chemotherapy. Results of the meta-analysis support the use of allopurinol mouthwash to prevent mucositis.

Is methotrexate toxicity reversible?

Conclusion. Methotrexate can result in reversible neurotoxicity in the form of white matter injury. DWI may be used in early detection of such changes; therefore, it provides a rapid, noninvasive readily available tool by which neurotoxicity can be early detected and treated.

What is the recommended therapy for prevention of oral mucositis?

Results: Results of the studies used in this systematic review of literature showed that laser therapy, cryotherapy, professional oral hygiene, antimicrobial agents, Royal jelly, L. brevis lozenges, Zync supplementation and Benzydamine are the best treatment or/and prevention methods for oral mucositis.

How does folinic acid work with methotrexate?

As a derivative of folic acid, folinic acid is useful as an antidote to folic acid antagonists (i.e., methotrexate, pyrimethamine). [6] Frequently referred to as “leucovorin rescue,” folinic acid is used to counteract the toxic effects of high-dose methotrexate therapy.

How is chemo mucositis treated?

Cryotherapy with ice chips has been shown to effectively attenuate the onset and severity of mucositis in patients undergoing bolus chemotherapy with 5-fluorouracil and melphalan. Patients should suck on ice chips for 30 minutes prior to and during the chemotherapy infusion.