Drug interactions
Glecaprevir / pibrentasvir + Methotrexate
Severity: Moderate
Glecaprevir / pibrentasvir 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
Glecaprevir and pibrentasvir inhibit P-gp, BCRP and OATP1B1/1B3, transporters that handle methotrexate. Methotrexate concentrations may increase, raising the risk of dose-related toxicity such as myelosuppression and mucositis.
What this interaction means in plain words
Glecaprevir / pibrentasvir 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.
Why it happens
Inhibition of P-gp, BCRP and OATP transporters reduces methotrexate efflux and hepatic uptake, increasing exposure.
What to do
Monitor complete blood count, liver tests and renal function during co-treatment. Reduce the methotrexate dose if signs of toxicity occur.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Glecaprevir / pibrentasvir 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 14 days on the web. No card needed.
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 Glecaprevir / pibrentasvir with Methotrexate?
MediHelp rates the interaction as moderate. Glecaprevir / pibrentasvir 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. Glecaprevir and pibrentasvir inhibit P-gp, BCRP and OATP1B1/1B3, transporters that handle methotrexate. Methotrexate concentrations may increase, raising the risk of dose-related toxicity such as myelosuppression and mucositis.
How serious is the interaction between Glecaprevir / pibrentasvir 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, liver tests and renal function during co-treatment. Reduce the methotrexate dose if signs of toxicity occur.
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.
