Drug interactions
Bacitracin + Methotrexate
Severity: Major
Bacitracin 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
Systemic bacitracin is nephrotoxic, and kidney injury can delay methotrexate elimination, raising methotrexate toxicity. The risk is mainly relevant to injectable bacitracin, which is rarely used now.
What this interaction means in plain words
Bacitracin 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.
Bacitracin belongs to Miscellaneous; Methotrexate belongs to Oncology.
Why it happens
Additive nephrotoxicity with reduced renal clearance of methotrexate.
What to do
Avoid parenteral bacitracin with methotrexate and choose a non-nephrotoxic antibiotic. If unavoidable, monitor renal function and methotrexate levels closely.
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 Bacitracin
- Bacitracin + Cidofovir Contraindicated
- Adefovir + Bacitracin Major
- Aldesleukin + Bacitracin Major
- Amikacin + Bacitracin Major
- Bacitracin + Carboplatin Major
- Bacitracin + Cisplatin Major
Frequently asked questions
Can I take Bacitracin with Methotrexate?
MediHelp rates the interaction as major. Bacitracin 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. Systemic bacitracin is nephrotoxic, and kidney injury can delay methotrexate elimination, raising methotrexate toxicity. The risk is mainly relevant to injectable bacitracin, which is rarely used now.
How serious is the interaction between Bacitracin 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 parenteral bacitracin with methotrexate and choose a non-nephrotoxic antibiotic. If unavoidable, monitor renal function and methotrexate levels closely.
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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