INFO - ACR guidelines for monitoring MTX toxicity

[Guest guest]

American College of Rheumatology

Guidelines for the Management of Rheumatoid Arthritis

2002

On monitoring for methotrexate toxicity:

CBC, creatinine, LFTs monthly

for the first 6 months; every

1-2 months thereafter. For

minor elevations in AST or

ALT (<2-fold ULN), repeat

testing in 2-4 weeks. For

moderate elevations in AST

or ALT (>2-fold but <3-

fold ULN), closely monitor,

with LFTs every 2-4 weeks

and dosage reduction as

necessary. For persistent

elevations in AST or ALT

(>2- or 3-fold ULN),

discontinue MTX and

perform liver biopsy as

necessary.

http://www.rheumatology.org/publications/guidelines/raguidelines02.asp?aud=mem

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org