Drug interactions
Fosinopril-hydrochlorothiazide + Methotrexate
Severity: Moderate
Fosinopril-hydrochlorothiazide 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
Thiazide diuretics may reduce renal elimination of methotrexate and have been reported to prolong its myelosuppressive effects. Dehydration and reduced kidney function from the diuretic, and ACE inhibitor effects on renal perfusion, may add to methotrexate accumulation. The risk is greatest with higher methotrexate doses.
What this interaction means in plain words
Fosinopril-hydrochlorothiazide 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.
Fosinopril-hydrochlorothiazide belongs to Cardiovascular; Methotrexate belongs to Oncology.
Why it happens
Reduced renal clearance of methotrexate through tubular competition and diuretic-related decrease in renal perfusion.
What to do
Monitor complete blood count and renal function, and consider methotrexate dose reduction, especially with high-dose regimens.
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 Fosinopril-hydrochlorothiazide
- Aliskiren + Fosinopril-hydrochlorothiazide Contraindicated
- Dofetilide + Fosinopril-hydrochlorothiazide Contraindicated
- Fosinopril-hydrochlorothiazide + Protein a column Contraindicated
- Fosinopril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Aldesleukin + Fosinopril-hydrochlorothiazide Major
- Amifostine + Fosinopril-hydrochlorothiazide Major
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 Fosinopril-hydrochlorothiazide with Methotrexate?
MediHelp rates the interaction as moderate. Fosinopril-hydrochlorothiazide 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. Thiazide diuretics may reduce renal elimination of methotrexate and have been reported to prolong its myelosuppressive effects. Dehydration and reduced kidney function from the diuretic, and ACE inhibitor effects on renal perfusion, may add to methotrexate accumulation. The risk is greatest with higher methotrexate doses.
How serious is the interaction between Fosinopril-hydrochlorothiazide 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 complete blood count and renal function, and consider methotrexate dose reduction, especially with high-dose regimens.
What other medicines interact with Fosinopril-hydrochlorothiazide?
MediHelp also lists interactions of Fosinopril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Protein a column. The full list is on the Fosinopril-hydrochlorothiazide page.
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