Methotrexate Amphotericin

Tubular cell toxicity This involves the cellular transport systems mentioned previously and is thus dose dependent to a degree. Examples of tubular cell toxins include aminoglycosides, calcineurin inhibitors, amphotericin, antiviral agents, cisplatin, methotrexate, contrast agents and cocaine. 

Clinically important, potentially hazardous interactions with amphotericin B, chlorotrianisene, colestyramine, diuretics, estrogens, furosemide, insulin, live vaccines, methotrexate, oral contraceptives, pancuronium, phenobarbital, rifampicin... 

Clinically important, potentially hazardous interactions with amphotericin B, benzodiazepines, doripenem, ertapenem, fludoxacillin, furosemide, glibenclamide, ketoprofen, ketorolac, methotrexate, NSAIDs, pemetrexed, penicillamine, penicillin G, penicillin V, salicylates, sulfamethoxazole, sulfonamides, torasemide, torsemide... 

Noninterfering acetaminophen, acyclovir, allopurinol, amoxicillin, amphotericin B, am-picillin, aspirin, azlocillin, bendrofluazide, bumetanide, buprenorphine, carbenidllin, cefazolin, cefotaxime, cefoxitin, ceftazidime, cefuroxime, cephalexin, chlorambucil, chloramphenicol, chlordiazepoxide, chlorpheniramine, chlorpropamide, cyclophosphamide, cyclosporin, C5d arabine, daunorubicin, dextropropoxyphene, dihydrocodeine, domperidone, flucytosine, furosemide, gentamicin, griseofulvin, melphalan, methotrexate, metochlo-pramide, metronidazole, miconazole, nabilone, netilmicin, nicotinamide, nitrazepam, penicillin G, piperacillin, prednisolone, procarbeizine, prochlorperazine, riboflavin, rifampin, sulfamethoxazole, thioguanine, tobramycin, tolbutamide, trimethoprim... 

Probenecid but not cidofovir alters zidovudine pharmacokinetics such that zidovudine doses should be reduced when probenecid is present, as should the doses of drugs similarly affected by probenecid fe.g., /i-lactam antibiotics, nonsteroidal anti-inflammatory drugs [NSAIDs], acyclovir, lorazepam, furosemide, methotrexate, theophylline, and rifampin). Concurrent nephrotoxic agents are contraindicated, and an interval of 1 week before beginning cidofovir treatment is recommended after prior exposure to aminoglycosides, intravenous pentamidine, amphotericin foscamet, NSAIDs, or contrast dye. Cidofovir and oral ganciclovir in combination are poorly tolerated at full doses. 

The manufacturer of conventional amphotericin B states that nephrotoxic antineoplastics should not be given concurrently except with great caution. Of the antineoplastics, cisplatin, ifosfamide and methotrexate are well known for their nephrotoxicity. Amphotericin also reduces the renal clearance of methotrexate , (p.642). 

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