Methotrexate
Dosing in kidney impairment
Renal Impairment Methotrexate elimination is reduced in patients with renal impairment [see Clinical Pharmacology]. Patients with renal impairment are at increased risk for methotrexate adverse reactions. Closely monitor patients with renal impairment [creatinine clearance (CLcr) less than 90 mL/min, Cockcroft-Gault] for adverse reactions.
Reduce the dosage or discontinue methotrexate tablets as appropriate [see Warnings and Precautions].
Dosing in liver impairment
Hepatic Impairment The pharmacokinetics and safety of methotrexate in patients with hepatic impairment is unknown. Patients with hepatic impairment may be at increased risk for methotrexate adverse reactions based on the elimination characteristics of methotrexate [see Clinical Pharmacology]. Closely monitor patients with hepatic impairment for adverse reactions.
Reduce the dosage or discontinue methotrexate tablets as appropriate [see Warnings and Precautions].