Описание
Clindamycin may reduce renal tubular secretion of methotrexate, raising methotrexate levels and increasing the risk of haematological and GI toxicity.
Механизм
Clindamycin can inhibit transporters involved in renal elimination of methotrexate (OAT1/OAT3), reducing clearance; additionally, antibiotic-mediated gut flora disruption alters the enterohepatic recycling of methotrexate.
Клиническое значение
Case reports describe pancytopenia and mucositis in patients receiving low-dose methotrexate after antibiotic therapy; routine monitoring is advised.
Тактика ведения
Monitor full blood count and renal function closely; if high-dose methotrexate is planned, consider alternative antibiotics or delay antibiotic initiation.
Медицинский отказ от ответственности
This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.