Gemfibrozil/methotrexate/piperacillin/tazobactam interaction: Acute renal failure (first report of an interaction between methotrexate and gemfibrozil): 2 case reports

Reactions Weekly | December 6, 2008| | Copyright

Two patients receiving high-dose methotrexate, one receiving concomitant piperacillin/tazobactam and one receiving concomitant gemfibrozil, developed acute renal failure.

Patient 1, a 58-year-old man with primary cerebral lymphoma, was treated with methotrexate 2.5 g/m^sup 2^ over 3 hours, as per the DeAngelis protocol [frequency not stated]. The first course was well tolerated and methotrexate was eliminated without delay. However, during the 3 hours after the second course he developed fever (38.5°C), prompting administration of piperacillin/tazobactam 4g/500mg every 6 hours as empirical ...

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