Summary
We examined the plasma and saliva levels of methotrexate (MTX) achieved during the treatment and rescue periods of ten patients receiving 42-h MTX infusions followed by citrovorum rescue. Saliva MTX levels were generally 1%–2% of the simultaneous plasma levels. Four patients developed severe oral mucositis; three patients developed mild to moderate oral toxicity, and three others had no evidence of mucositis. MTX levels in the patients with severe mucositis were not higher and did not persist longer than the levels achieved in patients with mild or absent toxicity. Attempts at reducing the severity of oral mucositis with topical citrovorum mouth-washes or with atropine to suppress salivation were unsuccessful. MTX-induced oral mucositis is not related to salivary MTX concentrations, and the use of topical citrovorum therapy or the supression of salivation does not appear to ameliorate this toxicity.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Bertino, J. R., Fischer, G. A.: Techniques for study of resistance to folic acid antagonists. Methods Med. Res. 10, 297–307 (1964)
Bleyer, W. A.: Forty-two hour methotrexate infusions: An interval report. In: Minutes of the New Drug Liaison Meeting: National Cancer Institute, Bethesda, Md. February 17–18, 1977. Bono, V. H. (ed.) pp. 159–166 on file with the Investigational Drug Branch, N.C.I.
Bleyer, W. A.: Clinical pharmacology of methotrexate. Cancer 41, 36–51 (1978)
Murray, C. et al.: High-dose methotrexate (V-MTX-CF) in osteogenic sarcoma: Detection of MTX in saliva and investigation of changes in taste, weight, and dietary intake. Am. Assoc. Cancer Res. 19, 158 (1978)
Stovner, J., Eugseth, J., Brennhovd, I.: Cancer therapy by intraarterial methotrexate infusion: Protection of mucous membranes by topically applied citrovorum factor with hyaluronidase. Cancer Chemother. Rep. 21, 147–148 (1962)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Oliff, A., Bleyer, W.A. & Poplack, D.G. Methotrexate-induced oral mucositis and salivary methotrexate concentrations. Cancer Chemother. Pharmacol. 2, 225–226 (1979). https://doi.org/10.1007/BF00258300
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00258300