Drug interactions
Hydrochlorothiazide-lisinopril + Methotrexate
Severity: Moderate
Hydrochlorothiazide-lisinopril 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
Reduced renal clearance of methotrexate by thiazides, and by volume depletion or renal impairment with ACE inhibitors, may increase methotrexate exposure. This can intensify bone marrow suppression, especially with higher methotrexate doses.
What this interaction means in plain words
Hydrochlorothiazide-lisinopril 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-lisinopril belongs to Cardiovascular; Methotrexate belongs to Oncology.
Why it happens
Reduced renal elimination of methotrexate through competition for tubular secretion and hemodynamic changes in renal function.
What to do
Monitor blood counts and renal function closely, particularly with high-dose methotrexate; consider avoiding the combination in impaired renal function.
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 Hydrochlorothiazide-lisinopril
- Dofetilide + Hydrochlorothiazide-lisinopril Contraindicated
- Hydrochlorothiazide-lisinopril + Sacubitril / valsartan Contraindicated
- Amifostine + Hydrochlorothiazide-lisinopril Major
- Amiloride + Hydrochlorothiazide-lisinopril Major
- Benazepril + Hydrochlorothiazide-lisinopril Major
- Bendroflumethiazide + Hydrochlorothiazide-lisinopril 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 Hydrochlorothiazide-lisinopril with Methotrexate?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-lisinopril 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. Reduced renal clearance of methotrexate by thiazides, and by volume depletion or renal impairment with ACE inhibitors, may increase methotrexate exposure. This can intensify bone marrow suppression, especially with higher methotrexate doses.
How serious is the interaction between Hydrochlorothiazide-lisinopril 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 blood counts and renal function closely, particularly with high-dose methotrexate; consider avoiding the combination in impaired renal function.
What other medicines interact with Hydrochlorothiazide-lisinopril?
MediHelp also lists interactions of Hydrochlorothiazide-lisinopril with, for example, Dofetilide, Sacubitril / valsartan, Amifostine. The full list is on the Hydrochlorothiazide-lisinopril page.
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