Drug interactions
Captopril-hydrochlorothiazide + Methotrexate
Severity: Moderate
Captopril-hydrochlorothiazide and Methotrexate: moderate 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
Thiazide diuretics can reduce methotrexate clearance and have been reported to prolong methotrexate-related myelosuppression. ACE inhibitors and diuretics can also reduce renal function, which further impairs methotrexate elimination. Higher doses of methotrexate carry greater risk.
What this interaction means in plain words
Captopril-hydrochlorothiazide and Methotrexate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Captopril-hydrochlorothiazide belongs to Cardiovascular; Methotrexate belongs to Oncology.
Why it happens
Reduced renal elimination of methotrexate through impaired tubular secretion and reduced renal perfusion.
What to do
Monitor complete blood counts and renal function closely, especially with intermediate or high-dose methotrexate. Consider alternative antihypertensives or reduce the methotrexate dose if toxicity appears.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Captopril-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 Captopril-hydrochlorothiazide
- Aliskiren + Captopril-hydrochlorothiazide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Aceclofenac + Captopril-hydrochlorothiazide Major
- Aldesleukin + Captopril-hydrochlorothiazide Major
- Amifostine + Captopril-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 Captopril-hydrochlorothiazide with Methotrexate?
MediHelp rates the interaction as moderate. Captopril-hydrochlorothiazide and Methotrexate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Thiazide diuretics can reduce methotrexate clearance and have been reported to prolong methotrexate-related myelosuppression. ACE inhibitors and diuretics can also reduce renal function, which further impairs methotrexate elimination. Higher doses of methotrexate carry greater risk.
How serious is the interaction between Captopril-hydrochlorothiazide and Methotrexate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor complete blood counts and renal function closely, especially with intermediate or high-dose methotrexate. Consider alternative antihypertensives or reduce the methotrexate dose if toxicity appears.
What other medicines interact with Captopril-hydrochlorothiazide?
MediHelp also lists interactions of Captopril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sacubitril / valsartan. The full list is on the Captopril-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.
