Drug interactions
Methotrexate + Palifermin
Severity: Major
Methotrexate and Palifermin: major 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
Palifermin given close to cytotoxic chemotherapy has worsened the severity and duration of oral mucositis, likely because it stimulates proliferation of epithelial cells that are then exposed to the cytotoxic agent. This applies to methotrexate given around the same time.
What this interaction means in plain words
Methotrexate and Palifermin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Methotrexate belongs to Oncology; Palifermin belongs to Miscellaneous.
Why it happens
Palifermin stimulates epithelial cell growth, which may increase their sensitivity to cytotoxic chemotherapy when given close in time.
What to do
Do not give palifermin within 24 hours before, during or after methotrexate chemotherapy. Schedule dosing with this interval.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Methotrexate and Palifermin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Palifermin
Frequently asked questions
Can I take Methotrexate with Palifermin?
MediHelp rates the interaction as major. Methotrexate and Palifermin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Palifermin given close to cytotoxic chemotherapy has worsened the severity and duration of oral mucositis, likely because it stimulates proliferation of epithelial cells that are then exposed to the cytotoxic agent. This applies to methotrexate given around the same time.
How serious is the interaction between Methotrexate and Palifermin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not give palifermin within 24 hours before, during or after methotrexate chemotherapy. Schedule dosing with this interval.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
