Drug interactions
Axicabtagene ciloleucel + Methotrexate
Severity: Major
Axicabtagene ciloleucel and Methotrexate: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Methotrexate may impair CAR T-cell expansion and persistence, potentially reducing efficacy of axicabtagene ciloleucel. It also adds to myelosuppression and infection risk after CAR T therapy.
What this interaction means in plain words
Axicabtagene ciloleucel and Methotrexate can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Axicabtagene ciloleucel belongs to Oncology; Methotrexate belongs to Oncology.
Why it happens
Antimetabolite effects on lymphocytes may blunt CAR T-cell proliferation and add to immune deficiency.
What to do
Avoid methotrexate around lymphodepletion and CAR T infusion unless essential, and follow product labeling for washout. Monitor for infection and cytopenias.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Methotrexate
- Acitretin + Methotrexate Contraindicated
- Adenovirus types 4 and 7 live + Methotrexate Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Methotrexate Contraindicated
- Ketorolac + Methotrexate Contraindicated
- Measles mumps and rubella vaccine live + Methotrexate Contraindicated
- Measles mumps and rubella vaccine + Methotrexate Contraindicated
Other interactions of Axicabtagene ciloleucel
Frequently asked questions
Can I take Axicabtagene ciloleucel with Methotrexate?
MediHelp rates the interaction as major. Axicabtagene ciloleucel and Methotrexate can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Methotrexate may impair CAR T-cell expansion and persistence, potentially reducing efficacy of axicabtagene ciloleucel. It also adds to myelosuppression and infection risk after CAR T therapy.
How serious is the interaction between Axicabtagene ciloleucel and Methotrexate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid methotrexate around lymphodepletion and CAR T infusion unless essential, and follow product labeling for washout. Monitor for infection and cytopenias.
What other medicines interact with Methotrexate?
MediHelp also lists interactions of Methotrexate with, for example, Acitretin, Adenovirus types 4 and 7 live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Methotrexate page.
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