Drug interactions
Methotrexate + Pantoprazole
Severity: Moderate
Methotrexate and Pantoprazole: 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
Pantoprazole may reduce methotrexate clearance and raise its concentrations. The risk is greatest with high-dose methotrexate, where toxicity can be serious.
What this interaction means in plain words
Methotrexate and Pantoprazole 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; Pantoprazole belongs to Gastrointestinal Tract.
Why it happens
Inhibition of renal tubular secretion of methotrexate, possibly through BCRP or other transporters.
What to do
With high-dose methotrexate, consider temporarily stopping the PPI or using an alternative acid suppressant. Monitor methotrexate levels and renal function.
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 Pantoprazole
- Pantoprazole + Rilpivirine Contraindicated
- Acalabrutinib + Pantoprazole Major
- Atazanavir + Pantoprazole Major
- Dacomitinib + Pantoprazole Major
- Dasatinib + Pantoprazole Major
- Erlotinib + Pantoprazole Major
Frequently asked questions
Can I take Methotrexate with Pantoprazole?
MediHelp rates the interaction as moderate. Methotrexate and Pantoprazole 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. Pantoprazole may reduce methotrexate clearance and raise its concentrations. The risk is greatest with high-dose methotrexate, where toxicity can be serious.
How serious is the interaction between Methotrexate and Pantoprazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: With high-dose methotrexate, consider temporarily stopping the PPI or using an alternative acid suppressant. Monitor methotrexate levels and renal function.
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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