Drug interactions
Methotrexate + Mycophenolate mofetil
Severity: Moderate
Methotrexate and Mycophenolate mofetil: 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 suppress lymphocyte proliferation, and methotrexate also causes marrow suppression, so combined use increases the risk of cytopenias and opportunistic infections. Renal impairment may further raise exposure to methotrexate and to mycophenolic acid metabolites.
What this interaction means in plain words
Methotrexate and Mycophenolate mofetil 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.
Methotrexate belongs to Oncology; Mycophenolate mofetil belongs to Miscellaneous.
Why it happens
Additive immunosuppressive and myelosuppressive pharmacodynamic effects via inhibition of purine synthesis and folate-dependent pathways.
What to do
Monitor complete blood counts and renal function regularly, and review the patient for signs of infection. Reduce the dose of one or both agents if cytopenias develop.
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 Mycophenolate mofetil
- Adenovirus types 4 and 7 live + Mycophenolate mofetil Contraindicated
- Bcg vaccine live + Mycophenolate mofetil Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Mycophenolate mofetil Contraindicated
- Measles mumps and rubella vaccine live + Mycophenolate mofetil Contraindicated
- Measles mumps rubella and varicella vaccine live + Mycophenolate mofetil Contraindicated
- Measles vaccine + Mycophenolate mofetil Contraindicated
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 Methotrexate with Mycophenolate mofetil?
MediHelp rates the interaction as moderate. Methotrexate and Mycophenolate mofetil 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 suppress lymphocyte proliferation, and methotrexate also causes marrow suppression, so combined use increases the risk of cytopenias and opportunistic infections. Renal impairment may further raise exposure to methotrexate and to mycophenolic acid metabolites.
How serious is the interaction between Methotrexate and Mycophenolate mofetil?
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 complete blood counts and renal function regularly, and review the patient for signs of infection. Reduce the dose of one or both agents if cytopenias develop.
What other medicines interact with Mycophenolate mofetil?
MediHelp also lists interactions of Mycophenolate mofetil with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Mycophenolate mofetil page.
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