A. FOLIC ACID ANALOGUES: METHOTREXATE, PEMETREXED, PRALATREXATE
Toxicity
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primary toxic effects are on bone marrow (danger of spontaneous hemorrhage or life-threatening infection) and GI epithelium
- mucositis, myelosuppression and thrombocytopenia reach their maximum in 5-10 days, and decrease rapidly thereafter
- note that things that decrease renal excretion of METHOTREXATE significantly increase bone marrow suppression
- pneumonitis (cough, fever and interstitial infiltrate)
- hepatic fibrosis
- alopecia, dermatitis
- MTX is abortifacaent