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This communication reports previously unreported side effects, severe bullous dermatosis and onycholysis, in three patients undergoing high-dose methotrexate and leucovorin calcium therapy, impacting their chemotherapy schedules.

This article reviews methotrexate's pharmacokinetics and toxicity, emphasizing the role of urinary excretion and leucovorin in avoiding most toxic reactions; it provides no new clinical results.

This case report highlights a rare instance of severe multi-organ involvement following a single dose of methotrexate for ectopic pregnancy, requiring intensive care but ultimately successfully treated with leucovorin and supportive care.