Drug interactions
Ciprofloxacin + Methotrexate
Severity: Moderate
Ciprofloxacin 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
Ciprofloxacin may raise methotrexate concentrations and prolong exposure, leading to myelosuppression, mucositis or renal toxicity. The risk is greater with high-dose methotrexate or reduced renal function.
What this interaction means in plain words
Ciprofloxacin 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.
Ciprofloxacin belongs to Anti Bacterial; Methotrexate belongs to Oncology.
Why it happens
Ciprofloxacin may inhibit renal tubular secretion of methotrexate, reducing its clearance.
What to do
Monitor blood counts, renal function and methotrexate levels when used with high-dose methotrexate. Consider an alternative antibiotic if toxicity develops.
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 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 Ciprofloxacin
- Agomelatine + Ciprofloxacin Contraindicated
- Ciprofloxacin + Fezolinetant Contraindicated
- Ciprofloxacin + Thioridazine Contraindicated
- Ciprofloxacin + Tizanidine Contraindicated
- Ciprofloxacin + Vandetanib Contraindicated
- Alosetron + Ciprofloxacin Major
Frequently asked questions
Can I take Ciprofloxacin with Methotrexate?
MediHelp rates the interaction as moderate. Ciprofloxacin 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. Ciprofloxacin may raise methotrexate concentrations and prolong exposure, leading to myelosuppression, mucositis or renal toxicity. The risk is greater with high-dose methotrexate or reduced renal function.
How serious is the interaction between Ciprofloxacin 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 blood counts, renal function and methotrexate levels when used with high-dose methotrexate. Consider an alternative antibiotic if toxicity develops.
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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