Drug interactions
Bcg intravesical live + Methotrexate
Severity: Major
Bcg intravesical live 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
Immunosuppression with methotrexate may reduce the effectiveness of intravesical BCG and increase the risk of disseminated BCG infection. Live BCG is generally avoided in immunosuppressed patients.
What this interaction means in plain words
Bcg intravesical live 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.
Why it happens
Impaired cell-mediated immunity reduces control of live attenuated mycobacteria and the immune response to BCG.
What to do
Avoid intravesical BCG during methotrexate therapy where possible, or consider an alternative bladder cancer therapy. If used, monitor closely for systemic BCG infection.
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
Frequently asked questions
Can I take Bcg intravesical live with Methotrexate?
MediHelp rates the interaction as major. Bcg intravesical live 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. Immunosuppression with methotrexate may reduce the effectiveness of intravesical BCG and increase the risk of disseminated BCG infection. Live BCG is generally avoided in immunosuppressed patients.
How serious is the interaction between Bcg intravesical live 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 intravesical BCG during methotrexate therapy where possible, or consider an alternative bladder cancer therapy. If used, monitor closely for systemic BCG infection.
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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