Drug interactions
Hydrochlorothiazide-losartan + Methotrexate
Severity: Moderate
Hydrochlorothiazide-losartan 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
Thiazides may reduce renal elimination of methotrexate and increase myelosuppression. Volume depletion and reduced renal function worsen the risk, and losartan can contribute to renal impairment. The risk is greatest with higher methotrexate doses.
What this interaction means in plain words
Hydrochlorothiazide-losartan 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-losartan belongs to Cardiovascular; Methotrexate belongs to Oncology.
Why it happens
Reduced renal clearance of methotrexate through tubular competition and diuretic-related volume depletion.
What to do
Monitor complete blood count and renal function closely, and consider reducing the methotrexate dose; avoid the combination 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 Hydrochlorothiazide-losartan
- Aliskiren + Hydrochlorothiazide-losartan Contraindicated
- Dofetilide + Hydrochlorothiazide-losartan Contraindicated
- Hydrochlorothiazide-losartan + Sparsentan Contraindicated
- Aceclofenac + Hydrochlorothiazide-losartan Major
- Aldesleukin + Hydrochlorothiazide-losartan Major
- Amifostine + Hydrochlorothiazide-losartan 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-losartan with Methotrexate?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-losartan 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. Thiazides may reduce renal elimination of methotrexate and increase myelosuppression. Volume depletion and reduced renal function worsen the risk, and losartan can contribute to renal impairment. The risk is greatest with higher methotrexate doses.
How serious is the interaction between Hydrochlorothiazide-losartan 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 closely, and consider reducing the methotrexate dose; avoid the combination with high-dose methotrexate.
What other medicines interact with Hydrochlorothiazide-losartan?
MediHelp also lists interactions of Hydrochlorothiazide-losartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-losartan page.
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