Drug interactions
Letermovir + Methotrexate
Severity: Moderate
Letermovir 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
Letermovir inhibits OATP1B1/1B3 and may increase exposure to methotrexate, whose hepatic uptake involves these transporters. This could raise the risk of methotrexate toxicity such as myelosuppression and mucositis.
What this interaction means in plain words
Letermovir 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.
Letermovir belongs to Anti Virals; Methotrexate belongs to Oncology.
Why it happens
Inhibition of OATP1B1/1B3-mediated hepatic uptake reduces methotrexate clearance.
What to do
Monitor blood counts, renal and hepatic function, and for signs of methotrexate toxicity. Consider reducing the methotrexate dose if toxicity appears.
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 Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
Frequently asked questions
Can I take Letermovir with Methotrexate?
MediHelp rates the interaction as moderate. Letermovir 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. Letermovir inhibits OATP1B1/1B3 and may increase exposure to methotrexate, whose hepatic uptake involves these transporters. This could raise the risk of methotrexate toxicity such as myelosuppression and mucositis.
How serious is the interaction between Letermovir 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, renal and hepatic function, and for signs of methotrexate toxicity. Consider reducing the methotrexate dose if toxicity appears.
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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