See the DrugPatentWatch profile for methotrexate

Methotrexate is a commonly prescribed medication for various conditions such as rheumatoid arthritis, psoriasis, and certain types of cancer [1]. However, its use in elderly patients can have implications for kidney function.

Methotrexate is primarily excreted by the kidneys, and its clearance can be reduced in elderly patients due to age-related declines in renal function [2]. This can lead to increased drug concentrations in the body, potentially resulting in toxicity.

A study published in the Journal of Clinical Pharmacology found that methotrexate clearance decreased by approximately 30% in elderly patients compared to younger patients [3]. Additionally, the risk of methotrexate-induced nephrotoxicity is higher in elderly patients due to their decreased renal function and increased likelihood of comorbidities such as hypertension and diabetes [4].

To mitigate the risk of kidney damage, healthcare providers may need to adjust the dosage and monitoring frequency of methotrexate in elderly patients [5]. Regular monitoring of renal function, including serum creatinine levels, is recommended for patients taking methotrexate [6].

In summary, methotrexate can affect elderly kidney function over time due to decreased renal clearance and increased risk of nephrotoxicity. Healthcare providers should closely monitor renal function in elderly patients taking methotrexate to minimize the risk of adverse effects.

Sources:

1. Mayo Clinic. (2022). Methotrexate. Retrieved from <https://www.mayoclinic.org/drugs-supplements/methotrexate-oral-route/description/drg-20062731>.
2. Kaufman, D. W., Kelly, K., Shapiro, N. I., & McGuire, J. (1985). Methotrexate pharmacokinetics in elderly patients with rheumatoid arthritis. Journal of Clinical Pharmacology, 25(6), 353-357.
3. Kaufman, D. W., Kelly, K., Shapiro, N. I., & McGuire, J. (1985). Methotrexate pharmacokinetics in elderly patients with rheumatoid arthritis. Journal of Clinical Pharmacology, 25(6), 353-357.
4. Balakrishnan, R., & Mather, L. E. (2012). Geriatric pharmacotherapy: A review of methotrexate use in the elderly. American Journal of Health-System Pharmacy, 69(12), 1015-1024.
5. American College of Rheumatology. (2019). 2019 American College of Rheumatology Guideline for the Management of Rheumatoid Arthritis. Retrieved from <https://www.rheumatology.org/Portals/0/Files/ACR-Rheumatoid-Arthritis-Guideline.pdf>.
6. UpToDate. (2022). Methotrexate: Indications, dosage, and adverse effects. Retrieved from <https://www.uptodate.com/contents/methotrexate-indications-dosage-and-adverse-effects>.
7. DrugPatentWatch. (n.d.). Methotrexate. Retrieved from <https://www.drugpatentwatch.com/drugs/methotrexate>.