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Nitrous Oxide and Rasuvo

Determining the interaction of Nitrous Oxide and Rasuvo and the possibility of their joint administration.

Check result:

Nitrous Oxide <> Rasuvo

Relevance: 11.02.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using methotrexate and nitrous oxide can increase the methotrexate levels in your body. This can cause pale skin, easy bruising or bleeding, unusual weakness, mouth sores, nausea, vomiting, black or bloody stools, and urinating less than usual or not at all. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: The use of nitrous oxide anesthesia may increase the risk of methotrexate-associated cytotoxicity. The proposed mechanism is that nitrous oxide increases the effects of methotrexate on tetrahydrofolate metabolism, resulting in greater toxicity. Several studies have reported a higher incidence of toxicity, including stomatitis, leucopenia, thrombocytopenia, and infections, when methotrexate, cyclophosphamide, and fluorouracil were administered to breast cancer patients within 6 to 36 hours of surgery.

MANAGEMENT: The concomitant use of nitrous oxide anesthesia with methotrexate should be avoided. Some authorities consider the use of nitrous oxide with methotrexate to be contraindicated (CA). If concomitant use is unavoidable, patients should be closely monitored for toxicity during the postoperative period. Intravenous hydration and calcium folinate (leucovorin) are recommended to decrease the incidence of methotrexate toxicity..

References

Ludwig Breast Cancer Study Group "On the safety of perioperative adjuvant chemotherapy with cyclophosphamide, methotrexate and 5-fluorouracil in breast cancer." Eur J Cancer Clin Oncol 24 (1988): 1305-8
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Cerner Multum, Inc. "Australian Product Information." O 0
Ermens AA, Schoester M, Spijkers LJ, Lindemans J, Abels J "Toxicity of methotrexate in rats preexposed to nitrous oxide." Cancer Res 49 (1989): 6337-41
Goldhirsch A, Gelber RD, Tattersall MN, Rudenstam CM "Methotrexate/nitrous-oxide toxic interaction in perioperative chemotherapy for early breast cancer." Lancet ii (1987): 151
Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink."

Nitrous Oxide

Generic Name: nitrous oxide

Brand name:

Synonyms: n.a.

What is Nitrous Oxide?

Rasuvo

Generic Name: methotrexate

Brand name: Methotrexate Sodium, Preservative Free, Otrexup, Rasuvo, Rheumatrex Dose Pack, Trexall, Xatmep

Synonyms: Rasuvo (injection), Rasuvo Injection

What is Rasuvo?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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