Methotrexate is a commonly used medication for various conditions such as rheumatoid arthritis, psoriasis, and certain types of cancer. However, it can cause toxicity, especially in older patients due to factors like decreased kidney function, drug interactions, and lower body reserves [1].

The treatment of methotrexate toxicity in older patients involves several steps. First, the medication should be discontinued immediately if toxicity is suspected. This is followed by supportive care, which may include hydration, urinary alkalinization, and administration of folic acid or leucovorin to reduce toxicity [1][2].

In severe cases, methotrexate toxicity may require hospitalization and more intensive treatments. These may include dialysis to remove methotrexate from the body, or the use of glucarpidase, an enzyme that rapidly breaks down methotrexate [1][2].

Preventing methotrexate toxicity is crucial, especially in older patients. This can be achieved through regular monitoring of blood counts and kidney function, adjusting the dose as necessary, and educating patients about the signs of toxicity [1].

It's important to note that while methotrexate can be a life-saving medication, its use should be carefully managed in older patients due to the increased risk of toxicity. Healthcare providers should consider the patient's overall health, kidney function, and potential drug interactions when prescribing methotrexate [1].

Sources:
[1] "Methotrexate Toxicity." American Society of Health-System Pharmacists, www.drugs.com/cg/methotrexate-toxicity.html.
[2] "Methotrexate." National Cancer Institute, www.cancer.gov/about-cancer/treatment/drugs/methotrexate.
[3] "Methotrexate." DrugPatentWatch, www.drugpatentwatch.com/drugs/methotrexate.