Drug interactions
Hydrochlorothiazide + Methotrexate
Severity: Moderate
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 volume depletion may impair kidney function, raising methotrexate levels. This can increase myelosuppression, particularly with higher methotrexate doses.
What this interaction means in plain words
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.
Hydrochlorothiazide belongs to Cardiovascular; Methotrexate belongs to Oncology.
Why it happens
Reduced renal clearance of methotrexate, with possible effects of diuretic-induced volume depletion.
What to do
Monitor complete blood counts and renal function, and reduce the methotrexate dose if toxicity develops; take particular care with high-dose methotrexate.
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 Hydrochlorothiazide
Frequently asked questions
Can I take Hydrochlorothiazide with Methotrexate?
MediHelp rates the interaction as moderate. 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 volume depletion may impair kidney function, raising methotrexate levels. This can increase myelosuppression, particularly with higher methotrexate doses.
How serious is the interaction between 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 counts and renal function, and reduce the methotrexate dose if toxicity develops; take particular care with high-dose methotrexate.
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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