Indian Journal of Medical and Paediatric Oncology

: 2019  |  Volume : 40  |  Issue : 3  |  Page : 424--426

High-dose methotrexate

Manikandan Dhanushkodi 
 Department of Medical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India

Correspondence Address:
Manikandan Dhanushkodi
Cancer Institute (WIA), 38, Sardar Patel Road, Chennai - 600 036, Tamil Nadu

High-dose methotrexate (HDMTX) is defined as methotrexate dose of ≥500 mg/m2. It is used in the treatment of acute lymphoblastic leukemia, osteosarcoma, and primary central nervous system lymphoma. Administration mandates adequate hydration; urine alkalinization; leucovorin rescue, monitoring of urine output, serum creatinine, and methotrexate levels. Delayed methotrexate clearance is managed by increasing hydration and leucovorin dose. Glucarpidase is the antidote for patients with renal toxicity. Studies from India have shown that HDMTX can be administered without monitoring of methotrexate levels with strict monitoring of urine pH, urine output, and serum creatinine and extended hydration and leucovorin doses.

How to cite this article:
Dhanushkodi M. High-dose methotrexate.Indian J Med Paediatr Oncol 2019;40:424-426

How to cite this URL:
Dhanushkodi M. High-dose methotrexate. Indian J Med Paediatr Oncol [serial online] 2019 [cited 2020 Sep 25 ];40:424-426
Available from:;year=2019;volume=40;issue=3;spage=424;epage=426;aulast=Dhanushkodi;type=0