Drug interactions
Influenza virus vaccine quadrivalent intranasal + Methotrexate
Severity: Contraindicated
Influenza virus vaccine quadrivalent intranasal and Methotrexate: contraindicated 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
The intranasal influenza vaccine contains live attenuated virus, which may replicate excessively in patients taking methotrexate and cause influenza illness. The immune response may also be reduced.
What this interaction means in plain words
Influenza virus vaccine quadrivalent intranasal and Methotrexate are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Methotrexate antimetabolite immunosuppression impairs control of the attenuated live virus.
What to do
Avoid the intranasal live vaccine in patients on immunosuppressive methotrexate regimens; use an inactivated injectable influenza vaccine instead.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Methotrexate
- Acitretin + Methotrexate Contraindicated
- Adenovirus types 4 and 7 live + Methotrexate Contraindicated
- Ketorolac + Methotrexate Contraindicated
- Measles mumps and rubella vaccine live + Methotrexate Contraindicated
- Measles mumps and rubella vaccine + Methotrexate Contraindicated
- Measles mumps rubella and varicella vaccine live + Methotrexate Contraindicated
Frequently asked questions
Can I take Influenza virus vaccine quadrivalent intranasal with Methotrexate?
MediHelp rates the interaction as contraindicated. Influenza virus vaccine quadrivalent intranasal and Methotrexate are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. The intranasal influenza vaccine contains live attenuated virus, which may replicate excessively in patients taking methotrexate and cause influenza illness. The immune response may also be reduced.
How serious is the interaction between Influenza virus vaccine quadrivalent intranasal and Methotrexate?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the intranasal live vaccine in patients on immunosuppressive methotrexate regimens; use an inactivated injectable influenza vaccine instead.
What other medicines interact with Methotrexate?
MediHelp also lists interactions of Methotrexate with, for example, Acitretin, Adenovirus types 4 and 7 live, Ketorolac. The full list is on the Methotrexate page.
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