Drug interactions
Cisplatin + Methotrexate
Severity: Major
Cisplatin and Methotrexate: major interaction.
Last updated Sources: US FDA label
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
Both drugs can damage the kidneys, and cisplatin also causes ototoxicity. Cisplatin-induced renal impairment can delay methotrexate elimination, raising the risk of severe myelosuppression and mucositis.
What this interaction means in plain words
Cisplatin 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.
Cisplatin belongs to Oncology; Methotrexate belongs to Oncology.
Why it happens
Additive nephrotoxicity with cisplatin-related renal impairment reducing methotrexate clearance.
What to do
Monitor creatinine, electrolytes, blood counts and methotrexate levels, and ensure vigorous hydration. Reduce or delay methotrexate if renal function worsens, and consider leucovorin rescue.
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 Cisplatin 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.
References
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 Cisplatin
- Cidofovir + Cisplatin Contraindicated
- Adefovir + Cisplatin Major
- Adenovirus types 4 and 7 live + Cisplatin Major
- Amikacin + Cisplatin Major
- Amphotericin b deoxycholate + Cisplatin Major
- Amphotericin b + Cisplatin Major
Frequently asked questions
Can I take Cisplatin with Methotrexate?
MediHelp rates the interaction as major. Cisplatin 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. Both drugs can damage the kidneys, and cisplatin also causes ototoxicity. Cisplatin-induced renal impairment can delay methotrexate elimination, raising the risk of severe myelosuppression and mucositis.
How serious is the interaction between Cisplatin 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 creatinine, electrolytes, blood counts and methotrexate levels, and ensure vigorous hydration. Reduce or delay methotrexate if renal function worsens, and consider leucovorin rescue.
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.
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.
