Drug Interactions With Methotrexate

More Information on Drug Interactions With Methotrexate

The following sections explain in detail the potentially negative interactions that can occur when methotrexate is taken with any of the drugs listed above.
 
Antibiotics
Antibiotics (especially those taken by mouth) may decrease or increase the amount of methotrexate in the bloodstream. Check with your healthcare provider before taking methotrexate with an antibiotic.
 
Azathioprine
Combining azathioprine with methotrexate may increase the risk of liver damage or dangerously low white blood cells. Your healthcare provider will need to monitor you closely if you must take these two medications together.
 
NSAIDs
It has been reported that combining some NSAIDs with high doses of methotrexate, such as those used to treat cancer or psoriasis, may dramatically increase the level of methotrexate in the blood, leading to severe toxicity and even death.
 
Studies suggest that lower doses of methotrexate, such as those used for rheumatoid arthritis, may be combined with NSAIDs if necessary, although extra monitoring may be required. If you take methotrexate, check with your healthcare provider before taking any NSAID, including nonprescription ones.
 
Phenytoin
Phenytoin may increase the risk of methotrexate toxicity. If you must take these medications together, you may need a lower-than-normal methotrexate dosage, and your healthcare provider will need to monitor you more closely.
 
Probenecid
Probenecid can affect the way the kidneys and the body handle methotrexate. This can cause methotrexate to build up in the bloodstream, possibly leading to toxicity. Check with your healthcare provider before taking these two medications together.
 
Proton Pump Inhibitors (PPIs)
Proton pump inhibitors may increase the level of methotrexate in the body and may cause it to stay in the body longer than usual. This may lead to methotrexate toxicity. Check with your healthcare provider before combining methotrexate with a PPI.
  
Retinoids
Combining a retinoid with methotrexate may increase the risk of liver damage. Check with your healthcare provider before taking such medications together.
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