Drug interactions
Ethanol + Methotrexate
Severity: Major
Ethanol 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
Alcohol and methotrexate are both hepatotoxic, and regular drinking increases the risk of liver injury, fibrosis and cirrhosis during methotrexate therapy. Heavy alcohol use may also worsen bone marrow and gastrointestinal toxicity.
What this interaction means in plain words
Ethanol 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
Additive hepatotoxicity through hepatocellular injury and fibrogenesis from both agents.
What to do
Advise patients to avoid alcohol or keep intake minimal, and monitor liver enzymes and blood counts regularly. Consider an alternative to methotrexate in patients with alcohol use disorder.
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 Ethanol 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
Frequently asked questions
Can I take Ethanol with Methotrexate?
MediHelp rates the interaction as major. Ethanol 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. Alcohol and methotrexate are both hepatotoxic, and regular drinking increases the risk of liver injury, fibrosis and cirrhosis during methotrexate therapy. Heavy alcohol use may also worsen bone marrow and gastrointestinal toxicity.
How serious is the interaction between Ethanol 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: Advise patients to avoid alcohol or keep intake minimal, and monitor liver enzymes and blood counts regularly. Consider an alternative to methotrexate in patients with alcohol use disorder.
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.
