A rare case of methotrexate and primaquine co-administration in a mantle cell lymphoma patient

Alan L. Myers; Jitesh D. Kawedia; Ahmed Nader; Jason R. Westin; Brandon R. Shank

doi:10.1111/jcpt.12849

A rare case of methotrexate and primaquine co-administration in a mantle cell lymphoma patient

Alan L. Myers
, Jitesh D. Kawedia
, Ahmed Nader
, Jason R. Westin
, Brandon R. Shank

Research output: Contribution to journal › Article › peer-review

Abstract

What is known and objective: High-dose methotrexate (HD-MTX) is associated with a plethora of adverse drug reactions and potential drug interactions (DIs). But there is a paucity of information regarding the safety of co-administering primaquine with HD-MTX. Case summary: A 65-year-old male patient was diagnosed with mantle cell lymphoma (MCL) with CNS involvement and treated with three cycles of IV HD-MTX. His case was further complicated by fungal pneumonia treated with primaquine during cycle-2. Serial blood sampling and subsequent population pharmacokinetics (PK) modelling suggests a possible distribution-mediated DI between the two drugs. What is new and conclusion: This is the first case report to highlight the safe co-administration of MTX and primaquine, despite a possible PK interaction.

Original language	English
Pages (from-to)	800-804
Number of pages	5
Journal	Journal of Clinical Pharmacy and Therapeutics
Volume	44
Issue number	5
DOIs	https://doi.org/10.1111/jcpt.12849
Publication status	Published - 1 Oct 2019
Externally published	Yes

Keywords

clinical pharmacokinetics
CNS dissemination
drug interaction
hematologic malignancy
mantle cell lymphoma
methotrexate
pharmacokinetics
primaquine
safety
therapeutic drug monitoring

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/jcpt.12849

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title = "A rare case of methotrexate and primaquine co-administration in a mantle cell lymphoma patient",

abstract = "What is known and objective: High-dose methotrexate (HD-MTX) is associated with a plethora of adverse drug reactions and potential drug interactions (DIs). But there is a paucity of information regarding the safety of co-administering primaquine with HD-MTX. Case summary: A 65-year-old male patient was diagnosed with mantle cell lymphoma (MCL) with CNS involvement and treated with three cycles of IV HD-MTX. His case was further complicated by fungal pneumonia treated with primaquine during cycle-2. Serial blood sampling and subsequent population pharmacokinetics (PK) modelling suggests a possible distribution-mediated DI between the two drugs. What is new and conclusion: This is the first case report to highlight the safe co-administration of MTX and primaquine, despite a possible PK interaction.",

keywords = "clinical pharmacokinetics, CNS dissemination, drug interaction, hematologic malignancy, mantle cell lymphoma, methotrexate, pharmacokinetics, primaquine, safety, therapeutic drug monitoring",

author = "Myers, \{Alan L.\} and Kawedia, \{Jitesh D.\} and Ahmed Nader and Westin, \{Jason R.\} and Shank, \{Brandon R.\}",

note = "Publisher Copyright: {\textcopyright} 2019 John Wiley \& Sons Ltd",

year = "2019",

month = oct,

day = "1",

doi = "10.1111/jcpt.12849",

language = "English",

volume = "44",

pages = "800--804",

journal = "Journal of Clinical Pharmacy and Therapeutics",

issn = "0269-4727",

publisher = "John Wiley and Sons Inc",

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}

TY - JOUR

T1 - A rare case of methotrexate and primaquine co-administration in a mantle cell lymphoma patient

AU - Myers, Alan L.

AU - Kawedia, Jitesh D.

AU - Nader, Ahmed

AU - Westin, Jason R.

AU - Shank, Brandon R.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - What is known and objective: High-dose methotrexate (HD-MTX) is associated with a plethora of adverse drug reactions and potential drug interactions (DIs). But there is a paucity of information regarding the safety of co-administering primaquine with HD-MTX. Case summary: A 65-year-old male patient was diagnosed with mantle cell lymphoma (MCL) with CNS involvement and treated with three cycles of IV HD-MTX. His case was further complicated by fungal pneumonia treated with primaquine during cycle-2. Serial blood sampling and subsequent population pharmacokinetics (PK) modelling suggests a possible distribution-mediated DI between the two drugs. What is new and conclusion: This is the first case report to highlight the safe co-administration of MTX and primaquine, despite a possible PK interaction.

AB - What is known and objective: High-dose methotrexate (HD-MTX) is associated with a plethora of adverse drug reactions and potential drug interactions (DIs). But there is a paucity of information regarding the safety of co-administering primaquine with HD-MTX. Case summary: A 65-year-old male patient was diagnosed with mantle cell lymphoma (MCL) with CNS involvement and treated with three cycles of IV HD-MTX. His case was further complicated by fungal pneumonia treated with primaquine during cycle-2. Serial blood sampling and subsequent population pharmacokinetics (PK) modelling suggests a possible distribution-mediated DI between the two drugs. What is new and conclusion: This is the first case report to highlight the safe co-administration of MTX and primaquine, despite a possible PK interaction.

KW - clinical pharmacokinetics

KW - CNS dissemination

KW - drug interaction

KW - hematologic malignancy

KW - mantle cell lymphoma

KW - methotrexate

KW - pharmacokinetics

KW - primaquine

KW - safety

KW - therapeutic drug monitoring

UR - https://www.scopus.com/pages/publications/85066078511

U2 - 10.1111/jcpt.12849

DO - 10.1111/jcpt.12849

M3 - Article

C2 - 31111511

AN - SCOPUS:85066078511

SN - 0269-4727

VL - 44

SP - 800

EP - 804

JO - Journal of Clinical Pharmacy and Therapeutics

JF - Journal of Clinical Pharmacy and Therapeutics

IS - 5

ER -

A rare case of methotrexate and primaquine co-administration in a mantle cell lymphoma patient

Abstract

Keywords

UN SDGs

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