Drug interactions
Methotrexate + Nitisinone
Severity: Moderate
Methotrexate and Nitisinone: 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
Nitisinone may increase methotrexate exposure by reducing its renal clearance. Higher levels increase the risk of myelosuppression, mucositis and renal or hepatic toxicity.
What this interaction means in plain words
Methotrexate and Nitisinone 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; Nitisinone belongs to Miscellaneous.
Why it happens
Nitisinone inhibits OAT1/OAT3-mediated renal tubular secretion of methotrexate.
What to do
Monitor blood counts, renal function and liver enzymes, and consider methotrexate levels with higher doses. Reduce the methotrexate dose if toxicity develops.
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 Nitisinone
- Adefovir + Nitisinone Moderate
- Bosentan + Nitisinone Moderate
- Celecoxib + Nitisinone Moderate
- Chlorpropamide + Nitisinone Moderate
- Diclofenac + Nitisinone Moderate
- Fluvastatin + Nitisinone Moderate
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 Nitisinone?
MediHelp rates the interaction as moderate. Methotrexate and Nitisinone 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. Nitisinone may increase methotrexate exposure by reducing its renal clearance. Higher levels increase the risk of myelosuppression, mucositis and renal or hepatic toxicity.
How serious is the interaction between Methotrexate and Nitisinone?
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 function and liver enzymes, and consider methotrexate levels with higher doses. Reduce the methotrexate dose if toxicity develops.
What other medicines interact with Nitisinone?
MediHelp also lists interactions of Nitisinone with, for example, Adefovir, Bosentan, Celecoxib. The full list is on the Nitisinone page.
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