C-blog

The absorption of methotrexate and melphalan can be reduced by food, but etoposide is unaffected.

Etoposide
The plasma etoposide concentrations of 11 patients with extensive small cell lung carcinoma given 100 mg oral doses were unaffected when taken with breakfast (milk, cornflakes, sugar, egg, sausage, bread, maganne, marmalade, coffee or tea). Also no changes were seen when the etoposide was taken with cyclophosphamide (100 mg/m2), methotrexate (12.5 mg/m2) or procarbazine (60 mg/m2) given orally.

Melphalan
A study in five patients with multiple myeloma showed that the half-life of melphalan (5 mg/m2) was unaffected when taken with a standardized breakfast, but the area under the curve was reduced to an average of 43% (range 0-78%). In one patient no melphalan was detectable when given with food.

Methotrexate
The peak serum methotrexate levels (measured at 1.5 h) of 10 children, following an oral dose, were reduced about 40% when taken with a milky meal (milk cornflakes, sugar, white bread and butter). The area under the 4 h concentration/time curve was reduced about 25%. A smaller reduction was seen after a ‘cirrus meal” (orange juice, fresh orange, white bread, butter and jam). The reasons are not understood.