Drug interactions
Isotretinoin + Methotrexate
Severity: Moderate
Isotretinoin 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
Both drugs can raise liver enzymes and cause hepatotoxicity, so using them together may increase the risk of liver injury. Both are also teratogenic, which requires strict pregnancy prevention.
What this interaction means in plain words
Isotretinoin 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.
Isotretinoin belongs to Dermatology; Methotrexate belongs to Oncology.
Why it happens
Additive hepatotoxicity.
What to do
Monitor liver enzymes at baseline and regularly during combined use, and stop one agent if significant elevation occurs. Ensure effective contraception in patients who can become pregnant.
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 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
Other interactions of Isotretinoin
- Demeclocycline + Isotretinoin Contraindicated
- Isotretinoin + Minocycline Contraindicated
- Isotretinoin + Oxytetracycline Contraindicated
- Isotretinoin + Palovarotene Contraindicated
- Aminolevulinic acid + Isotretinoin Major
- Doxycycline + Isotretinoin Major
Frequently asked questions
Can I take Isotretinoin with Methotrexate?
MediHelp rates the interaction as moderate. Isotretinoin 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. Both drugs can raise liver enzymes and cause hepatotoxicity, so using them together may increase the risk of liver injury. Both are also teratogenic, which requires strict pregnancy prevention.
How serious is the interaction between Isotretinoin 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 liver enzymes at baseline and regularly during combined use, and stop one agent if significant elevation occurs. Ensure effective contraception in patients who can become pregnant.
What other medicines interact with Methotrexate?
MediHelp also lists interactions of Methotrexate with, for example, Acitretin, Adenovirus types 4 and 7 live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Methotrexate page.
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