Drug interactions
L-methylfolate + Methotrexate
Severity: Minor
L-methylfolate and Methotrexate: minor 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
Methotrexate blocks dihydrofolate reductase, but L-methylfolate is already a reduced folate and bypasses this block. Supplementation may therefore reduce some methotrexate toxicities, and high doses could theoretically weaken methotrexate efficacy, although low-dose folate is routinely used with methotrexate.
What this interaction means in plain words
L-methylfolate and Methotrexate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
L-methylfolate belongs to Miscellaneous; Methotrexate belongs to Oncology.
Why it happens
L-methylfolate bypasses methotrexate-induced inhibition of dihydrofolate reductase, replenishing folate pools.
What to do
Folate supplementation is usually acceptable and often beneficial with low-dose methotrexate; avoid dosing around the methotrexate dose when possible. Monitor disease response and toxicity.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 L-methylfolate
Frequently asked questions
Can I take L-methylfolate with Methotrexate?
MediHelp rates the interaction as minor. L-methylfolate and Methotrexate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Methotrexate blocks dihydrofolate reductase, but L-methylfolate is already a reduced folate and bypasses this block. Supplementation may therefore reduce some methotrexate toxicities, and high doses could theoretically weaken methotrexate efficacy, although low-dose folate is routinely used with methotrexate.
How serious is the interaction between L-methylfolate and Methotrexate?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Folate supplementation is usually acceptable and often beneficial with low-dose methotrexate; avoid dosing around the methotrexate dose when possible. Monitor disease response and toxicity.
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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