Drug interactions
Charcoal + Methotrexate
Severity: Moderate
Charcoal 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
Activated charcoal adsorbs methotrexate in the gut and interrupts its enterohepatic circulation, decreasing exposure. This can reduce therapeutic effect with routine use but can help limit toxicity in overdose.
What this interaction means in plain words
Charcoal 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.
Charcoal belongs to Gastrointestinal Tract; Methotrexate belongs to Oncology.
Why it happens
Charcoal binds methotrexate in the gastrointestinal lumen, reducing absorption and biliary reabsorption.
What to do
Do not give charcoal with oral methotrexate therapy; separate doses by several hours if charcoal is needed. In toxicity, charcoal may be used alongside leucovorin and monitoring of methotrexate levels and renal function.
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?
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Other interactions of Charcoal
- Charcoal + Citalopram Moderate
- Charcoal + Digoxin Moderate
- Charcoal + Leflunomide Moderate
- Charcoal + Theophylline Moderate
- Charcoal + Tiratricol Moderate
- Acarbose + Charcoal Minor
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 Charcoal with Methotrexate?
MediHelp rates the interaction as moderate. Charcoal 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. Activated charcoal adsorbs methotrexate in the gut and interrupts its enterohepatic circulation, decreasing exposure. This can reduce therapeutic effect with routine use but can help limit toxicity in overdose.
How serious is the interaction between Charcoal 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: Do not give charcoal with oral methotrexate therapy; separate doses by several hours if charcoal is needed. In toxicity, charcoal may be used alongside leucovorin and monitoring of methotrexate levels and renal function.
What other medicines interact with Charcoal?
MediHelp also lists interactions of Charcoal with, for example, Citalopram, Digoxin, Leflunomide. The full list is on the Charcoal page.
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