Drug interactions
Dengue vaccine + Methotrexate
Severity: Major
Dengue vaccine and Methotrexate: major interaction.
Last updated Sources: UK SmPC
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
Dengue vaccine is a live attenuated vaccine, and methotrexate immunosuppression may reduce its response and raise the risk of vaccine-related infection. Use in immunosuppressed patients is generally not recommended.
What this interaction means in plain words
Dengue vaccine 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.
Why it happens
Methotrexate suppresses lymphocyte proliferation, which blunts vaccine immunity and permits replication of live attenuated virus.
What to do
Avoid giving the live vaccine during methotrexate therapy; vaccinate before treatment or after immunosuppression has been stopped for an appropriate interval.
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?
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References
- Jylamvo 2 mg/ml oral solution - SmPC sections 4.3/4.5 (class statement: live vaccines; "Concurrent vaccination with live vaccines") — electronic medicines compendium (UK SmPC)
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 Dengue vaccine with Methotrexate?
MediHelp rates the interaction as major. Dengue vaccine 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. Dengue vaccine is a live attenuated vaccine, and methotrexate immunosuppression may reduce its response and raise the risk of vaccine-related infection. Use in immunosuppressed patients is generally not recommended.
How serious is the interaction between Dengue vaccine 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: Avoid giving the live vaccine during methotrexate therapy; vaccinate before treatment or after immunosuppression has been stopped for an appropriate interval.
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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