Drug interactions
Hydrochlorothiazide-telmisartan + Methotrexate
Severity: Moderate
Hydrochlorothiazide-telmisartan 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 volume depletion can worsen this. Elevated methotrexate exposure can cause more myelosuppression and renal toxicity. Thiazides may also exacerbate neutropenia. The risk is greater with higher methotrexate doses and in renal impairment.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan 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-telmisartan belongs to Cardiovascular; Methotrexate belongs to Oncology.
Why it happens
Reduced renal elimination of methotrexate through volume contraction and competition for tubular secretion, with possible additive hematologic effects.
What to do
Monitor blood counts and renal function, especially with high-dose methotrexate. Ensure adequate hydration and consider an alternative antihypertensive when methotrexate is dosed intensively.
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-telmisartan
- Aliskiren + Hydrochlorothiazide-telmisartan Contraindicated
- Dofetilide + Hydrochlorothiazide-telmisartan Contraindicated
- Hydrochlorothiazide-telmisartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-telmisartan Major
- Amifostine + Hydrochlorothiazide-telmisartan Major
- Amiloride + Hydrochlorothiazide-telmisartan 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-telmisartan with Methotrexate?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-telmisartan 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 volume depletion can worsen this. Elevated methotrexate exposure can cause more myelosuppression and renal toxicity. Thiazides may also exacerbate neutropenia. The risk is greater with higher methotrexate doses and in renal impairment.
How serious is the interaction between Hydrochlorothiazide-telmisartan 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, especially with high-dose methotrexate. Ensure adequate hydration and consider an alternative antihypertensive when methotrexate is dosed intensively.
What other medicines interact with Hydrochlorothiazide-telmisartan?
MediHelp also lists interactions of Hydrochlorothiazide-telmisartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-telmisartan page.
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