3 Interactions found for:
Drug Interactions
A total of 724 medications are known to interact with methotrexate. Add another medication to view potential interactions with this medication.
Drug and Food Interactions
Moderate
Methotrexate
+ Food
The following applies to the ingredients: Methotrexate
Caffeine may reduce the effectiveness of methotrexate in the treatment of arthritis. If you are receiving methotrexate for arthritis, you may want to limit your intake of caffeine-containing foods and medications. Check with your doctor or pharmacist if you have concerns or are uncertain what products may contain caffeine.
The following applies to the ingredients: Methotrexate
Methotrexate may cause liver problems, and using it with other medications that can also affect the liver such as ethanol may increase that risk. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
The following applies to the ingredients: Methotrexate
Caffeine may reduce the effectiveness of methotrexate in the treatment of arthritis. If you are receiving methotrexate for arthritis, you may want to limit your intake of caffeine-containing foods and products. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. Your doctor may be able to prescribe alternatives that do not interact. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Drug and Pregnancy Interactions
Major
Methotrexate
+ Pregnancy
The following applies to the ingredients: Methotrexate
Professional Content
AU, UK: Use is contraindicated.
US: Use is contraindicated for all indications except oncology.
AU TGA pregnancy category: D
US FDA pregnancy category: X (psoriasis and rheumatoid arthritis); Not assigned (all other conditions)
Risk Summary: This drug can cause teratogenic effects or fetal death when administered to a pregnant woman.
Comments:
-This drug should be used in the treatment of neoplastic diseases only when the potential benefit outweighs the risk to the fetus.
-This drug affects spermatogenesis and oogenesis and may temporarily impair fertility.
-If the injection formulation of this drug is required to treat a neoplastic disease during pregnancy, it is advisable to opt for the preservative-free formulation since benzyl alcohol, which is a preservative, can pass through the placenta.
-Women of childbearing potential should not be started on this drug until pregnancy is excluded and should be fully counseled on the serious risk to the fetus should they become pregnant while undergoing treatment.
-Pregnancy should be avoided if either partner is receiving this drug, during and for a minimum of 3 months after therapy is completed for male patients, and during and for at least one ovulatory cycle after therapy is completed for female patients.
-Advise females of reproductive potential to use effective contraception during and for 6 months after the final dose of this drug.
This drug causes teratogenic effects, embryotoxicity, abortion, and fetal defects in humans. It has also been reported to cause impairment of fertility, oligospermia, and menstrual dysfunction in humans, during and for a short period after cessation of therapy.
A study examined the effects of this drug on pregnancy outcomes. The study found that pregnant women exposed to this drug at a dose equal to or less than 30 mg/week had a higher rate of spontaneous abortion/miscarriage (42.5%) compared to both unexposed patients with autoimmune disease (22.5%) and unexposed patients with non-autoimmune disease (17.3%). Additionally, among live births, pregnant women exposed to methotrexate had a higher rate of major birth defects compared to both groups of unexposed patients (2.9%). The study concluded that the major birth defects observed in pregnancies exposed to methotrexate were not always consistent with the expected adverse developmental outcomes associated with methotrexate use.
AU TGA pregnancy category D: Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts should be consulted for further details.
US FDA pregnancy category X: Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D and X are being phased out.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Methotrexate Sodium (methotrexate)." Teva Pharmaceuticals (formerly IVAX) (2017):
Drug and Breastfeeding Interactions
Major
Methotrexate
+ Breastfeeding
The following applies to the ingredients: Methotrexate
Professional Content
Use is contraindicated.
Excreted into human milk: Yes
Comments:
-The effects in the nursing infant or on milk production are unknown.
-Lactating women should be instructed not to breastfeed during treatment with this drug and for 1 week after the final dose.
Limited literature is available regarding the presence of this drug in human milk, indicating that it is present in minimal quantities. The highest ratio of this drug concentration in breast milk compared to plasma concentration reported is 0.08:1.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):
- "Product Information. Methotrexate Sodium (methotrexate)." Teva Pharmaceuticals (formerly IVAX) (2017):
Therapeutic Duplication Warnings
No warnings were found for your selected drugs.Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Switch to: Professional Interactions
| Drug Interaction Classification | |
|---|---|
These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication. |
|
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
| Unknown | No interaction information available. |
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