Drug interactions
Hepatitis b vaccine + Methotrexate
Severity: Moderate
Hepatitis b vaccine 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
Methotrexate is immunosuppressive and can reduce the antibody response to hepatitis B vaccination. Patients may fail to reach protective titers, and this is relevant to those at higher risk of exposure.
What this interaction means in plain words
Hepatitis b vaccine 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
Methotrexate suppresses lymphocyte proliferation, reducing the humoral immune response to vaccination.
What to do
Vaccinate before starting methotrexate where possible, and measure anti-HBs titers after the series. Revaccinate or use a higher-dose schedule if the titers are inadequate.
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
Frequently asked questions
Can I take Hepatitis b vaccine with Methotrexate?
MediHelp rates the interaction as moderate. Hepatitis b vaccine 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. Methotrexate is immunosuppressive and can reduce the antibody response to hepatitis B vaccination. Patients may fail to reach protective titers, and this is relevant to those at higher risk of exposure.
How serious is the interaction between Hepatitis b vaccine 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: Vaccinate before starting methotrexate where possible, and measure anti-HBs titers after the series. Revaccinate or use a higher-dose schedule if the titers are inadequate.
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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