Drug interactions
Denosumab + Methotrexate
Severity: Moderate
Denosumab 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
Denosumab has been associated with serious infections, and methotrexate adds immunosuppression. Patients on both may have a higher risk of infections such as skin infections and cellulitis.
What this interaction means in plain words
Denosumab 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.
Denosumab belongs to Oncology; Methotrexate belongs to Oncology.
Why it happens
Additive immunosuppression; denosumab modulates RANKL-related immune signaling while methotrexate suppresses immune cell proliferation.
What to do
Counsel patients to report signs of infection promptly and monitor for infection during therapy. Treat infections early and reassess need for therapy if serious infection occurs.
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 Denosumab
- Abatacept + Denosumab Moderate
- Adalimumab + Denosumab Moderate
- Alefacept + Denosumab Moderate
- Alemtuzumab + Denosumab Moderate
- Anakinra + Denosumab Moderate
- Azacitidine + Denosumab Moderate
Frequently asked questions
Can I take Denosumab with Methotrexate?
MediHelp rates the interaction as moderate. Denosumab 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. Denosumab has been associated with serious infections, and methotrexate adds immunosuppression. Patients on both may have a higher risk of infections such as skin infections and cellulitis.
How serious is the interaction between Denosumab 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: Counsel patients to report signs of infection promptly and monitor for infection during therapy. Treat infections early and reassess need for therapy if serious infection occurs.
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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