Drug interactions
Hydrochlorothiazide-olmesartan + Methotrexate
Severity: Moderate
Hydrochlorothiazide-olmesartan 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 methotrexate renal clearance and have been reported to prolong myelosuppression. The risk is greatest with high-dose methotrexate or reduced renal function.
What this interaction means in plain words
Hydrochlorothiazide-olmesartan 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-olmesartan belongs to Cardiovascular; Methotrexate belongs to Oncology.
Why it happens
Reduced renal elimination of methotrexate through competition for tubular secretion and volume depletion; ARB-related renal effects may add to this.
What to do
Monitor blood counts and renal function closely, particularly with higher methotrexate doses, and consider an alternative antihypertensive if toxicity develops.
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-olmesartan
- Aliskiren + Hydrochlorothiazide-olmesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-olmesartan Contraindicated
- Hydrochlorothiazide-olmesartan + Sparsentan Contraindicated
- Acemetacin + Hydrochlorothiazide-olmesartan Major
- Amifostine + Hydrochlorothiazide-olmesartan Major
- Amiloride + Hydrochlorothiazide-olmesartan 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-olmesartan with Methotrexate?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-olmesartan 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 methotrexate renal clearance and have been reported to prolong myelosuppression. The risk is greatest with high-dose methotrexate or reduced renal function.
How serious is the interaction between Hydrochlorothiazide-olmesartan 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 higher methotrexate doses, and consider an alternative antihypertensive if toxicity develops.
What other medicines interact with Hydrochlorothiazide-olmesartan?
MediHelp also lists interactions of Hydrochlorothiazide-olmesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-olmesartan page.
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