Hemoperfusion for methotrexate removal

Thomas P. Gibson*, Steven D. Reich, Frank A. Krumlovsky, Peter Ivanovich

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Removal of methotrexate by Amberlite XAD-4 hemoperfusion was determined in a patient with metastatic breast carcinoma. During 4 hr of hemoperfusion the plasma concentration of methotrexate fell from 5.5 × 10-7 M to 3.1 × 10-7 M. After hemoperfusion methotrexate concentration increased as a consequence of multicompartmental pharmacokinetics to 5.5 × 10-7 M and then slowly declined. Plasma methotrexate clearance decreased from 79 ml/min 30 min into hemoperfusion to 28 mllmin at the conclusion. In vitro clearance of methotrexate by 17 artificial kidneys, Amberlite XAD-4, and uncoated charcoal was determined. Uncoated charcoal had the greatest clearance of methotrexate of all the devices tested. We conclude that: (1) Amberlite XAD-4 transiently reduces plasma methotrexate concentration; (2) in vitro, charcoal hemoperfusion is more effective than XAD-4 in removing methotrexate; (3) as a consequence of the multicompartmental pharmacokinetics of methotrexate a postperfusion rebound in plasma methotrexate concentration is to be expected.

Original languageEnglish (US)
Pages (from-to)351-355
Number of pages5
JournalClinical pharmacology and therapeutics
Issue number3
StatePublished - Mar 1978
Externally publishedYes

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology


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