Copyright ©The Author(s) 2017.
World J Hepatol. Sep 18, 2017; 9(26): 1092-1100
Published online Sep 18, 2017. doi: 10.4254/wjh.v9.i26.1092
Table 1 Management of suspected methotrexate toxicity
Transaminase monitoringCommencingEvery 2 wk
Adjusting doseEvery 2 wk
Stable doseEvery 12 wk
Elevated transaminasesNew persistent elevationReduce methotrexate, investigate
New elevation greater than 3 times upper limit normalWithdraw methotrexate, investigate, methotrexate may be restarted after normalisation
Liver biopsyIndicationInvestigation of other potential causes of elevated transaminases
Very rarely for confirmation of methotrexate induced toxicity