Drug interactions
Candesartan-hydrochlorothiazide + Methotrexate
Severity: Major
Candesartan-hydrochlorothiazide 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
Thiazides may reduce renal elimination of methotrexate and have been reported to prolong myelosuppression. Angiotensin receptor blockers and volume depletion can also impair renal function, raising methotrexate exposure and toxicity.
What this interaction means in plain words
Candesartan-hydrochlorothiazide 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.
Candesartan-hydrochlorothiazide belongs to Cardiovascular; Methotrexate belongs to Oncology.
Why it happens
Reduced renal clearance of methotrexate through competition for tubular secretion and reduced renal perfusion.
What to do
Monitor blood counts and renal function closely, particularly with higher methotrexate doses, and consider dose reduction or an alternative antihypertensive.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Candesartan-hydrochlorothiazide and Methotrexate, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Candesartan-hydrochlorothiazide
- Aliskiren + Candesartan-hydrochlorothiazide Contraindicated
- Candesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Candesartan-hydrochlorothiazide + Sparsentan Contraindicated
- Acemetacin + Candesartan-hydrochlorothiazide Major
- Amifostine + Candesartan-hydrochlorothiazide Major
- Amiloride + Candesartan-hydrochlorothiazide Major
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 Candesartan-hydrochlorothiazide with Methotrexate?
MediHelp rates the interaction as major. Candesartan-hydrochlorothiazide 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. Thiazides may reduce renal elimination of methotrexate and have been reported to prolong myelosuppression. Angiotensin receptor blockers and volume depletion can also impair renal function, raising methotrexate exposure and toxicity.
How serious is the interaction between Candesartan-hydrochlorothiazide 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: Monitor blood counts and renal function closely, particularly with higher methotrexate doses, and consider dose reduction or an alternative antihypertensive.
What other medicines interact with Candesartan-hydrochlorothiazide?
MediHelp also lists interactions of Candesartan-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Candesartan-hydrochlorothiazide page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
