Question:
Administration of which of the following drugs requires alkalinization of urine?
Administration of which of the following drugs requires alkalinization of urine?
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Think of the drug that crystallises in acidic renal tubules during high-dose therapy.
Updated On: Jun 24, 2026
- Cytosine arabinoside
- Methotrexate
- Cisplatin
- Ifosfamide
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Verified By Collegedunia
The Correct Option is B
Solution and Explanation
Step 1: The question asks which chemotherapeutic drug needs urinary alkalinization during administration to prevent toxicity.
Step 2: Methotrexate, especially in high-dose regimens, can precipitate in the renal tubules and cause crystalluria and acute kidney injury because methotrexate and its metabolite 7-hydroxymethotrexate are poorly soluble in acidic urine.
Step 3: Alkalinizing the urine to a pH greater than 7 markedly increases the solubility of methotrexate, preventing tubular precipitation and protecting the kidneys. This is done with sodium bicarbonate along with vigorous hydration.
Step 4: Cytosine arabinoside (cytarabine) does not require urinary alkalinization. Cisplatin requires aggressive hydration and mannitol diuresis but not specifically alkalinization. Ifosfamide requires mesna to prevent hemorrhagic cystitis, not urinary alkalinization.
Conclusion: The printed key marks option B (Methotrexate), which is medically correct.
Step 2: Methotrexate, especially in high-dose regimens, can precipitate in the renal tubules and cause crystalluria and acute kidney injury because methotrexate and its metabolite 7-hydroxymethotrexate are poorly soluble in acidic urine.
Step 3: Alkalinizing the urine to a pH greater than 7 markedly increases the solubility of methotrexate, preventing tubular precipitation and protecting the kidneys. This is done with sodium bicarbonate along with vigorous hydration.
Step 4: Cytosine arabinoside (cytarabine) does not require urinary alkalinization. Cisplatin requires aggressive hydration and mannitol diuresis but not specifically alkalinization. Ifosfamide requires mesna to prevent hemorrhagic cystitis, not urinary alkalinization.
Conclusion: The printed key marks option B (Methotrexate), which is medically correct.
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