METHOTREXATE SHOULD NOT BE TAKEN WITH MEALS A study in children shows delayed absorption with food. part icularly milk Oral methotrexate is important in the maintenance treatment of children with acute lymphoblastic leukemia (ALL). An association between relapse rate and l ow serum levels I hour after administration has been suggest, ed . In 10 children (3 -15 years old) with A Lt . peak serum methotruate levels were significantly reduced by a milky meal. They were studied after a standard dose of methotrexate (1 Smg/m ' ) with 20ml of water in the fastin g state. with a mil ky meal and with a citrus meal . Serum methotre)(ate levels were generally lower when the drug was laken with a mil ky meal. An hour after the dose with a milky meal the mean drug l evel was Sig nifICant ly lower than after a dose on fas ting or wi th the ci trus meal. Be fore I hour and aft er J hours, mean levels did not differ sig ni ficantly between the] studies. Up to ] hours, mean methotrexate levels with the citrus meal were lowerthan with no food, but not significantly. The same was true of peak levels with the citrus meal. The time of peak was changed by both meals - significantly by the milky meal but not the citrus meal. The area under the absorption curve was Sig nificantly reduced with the milky meal (liS fasting), but the difference between the citrus meal and no food was not significant. Pi nkerton. C.R. a aI. : Unl:el 2: 944 (Nov I. 1980) 0156-2703/ 80/ 1122-0013 sao.50/0 CADIS Press INPHARMA 22 Nov 1980 13

METHOTREXATE SHOULD NOT BE TAKEN WITH MEALS

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METHOTREXATE SHOULD NOT BE TAKEN WITH MEALS

A study in children shows delayed absorption with food. particularly milk Oral methotrexate is important in the maintenance treatment of children with acute lymphoblastic leukemia (ALL). An association between relapse rate and low serum levels I hour after administration has been suggest,ed. In 10 children (3 -15 years old) with A Lt. peak serum methotruate levels were significantly reduced by a milky meal. They were studied after a standard dose of methotrexate (1 Smg/m' ) with 20ml of water in the fasting state. with a milky meal and with a citrus meal. Serum methotre)(ate levels were generally lower when the drug was laken with a mil ky meal. An hour after the dose with a milky meal the mean drug level was SignifICantly lower than after a dose on fasting or with the citrus meal. Before I hour and after J hours, mean levels did not differ significant ly between the] studies. Up to ] hours, mean methotrexate levels with the citrus meal were lowerthan with no food, but not significantly . The same was true of peak levels with the citrus meal. The time of peak was changed by both meals - s ignificantly by the milky meal but not the citrus meal. The area under the absorption curve was Significantly reduced with the milky meal (liS fasting), but the difference between the citrus meal and no food was not significant. Pinkerton. C.R. a aI. : Unl:el 2: 944 (Nov I . 1980)

0156-2703/ 80/ 1122-0013 sao.50/0 CADIS Press INPHARMA 22 Nov 1980 13