We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Methotrexate Excretion Patterns and Renal Toxicity After Intravenous Injection or Arterial Infusion

Devendra D. Patel, MS, FRCS; Fred R. Morgenthaler, MD; Amir M. Khazei, MD; Robert Grimaldi, MS; Elton Watkins Jr., MD
Arch Surg. 1969;98(3):305-308. doi:10.1001/archsurg.1969.01340090081012.
Text Size: A A A
Published online


The cancer chemotherapy group at the Lahey Clinic Foundation has been active in using regional intraarterial infusion chemotherapy of far-advanced solid tumors in various body regions.1 Problems have been encountered during regional therapy with the folic acid antagonist, methotrexate. If methotrexate is administered regionally in patients with impaired renal function, systemic toxic reactions to the drug are seen at low levels of dosage, presumably because of impaired excretion of drug by the kidneys. In the individual with normal renal function, no methotrexate is detectable in the serum shortly after an intravenous dose.2 When renal function is impaired, appreciable amounts of the drug are present in the serum, even after 48 hours.3 The current experiments were carried out to study the dynamics of enhanced drug toxicity observed in association with impaired renal function.

Experimental Procedure  Female mongrel dogs weighing between 20 and 25 kg (44 and 55 1b)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.