Drug interactions
Methotrexate + Pegaspargase
Severity: Moderate
Methotrexate and Pegaspargase: 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
Asparaginase depletes asparagine and inhibits protein synthesis, which can blunt methotrexate activity in cells that depend on cell-cycle progression. Sequence of administration therefore influences efficacy and toxicity.
What this interaction means in plain words
Methotrexate and Pegaspargase 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; Pegaspargase belongs to Oncology.
Why it happens
Pharmacodynamic antagonism, as asparaginase-induced inhibition of protein synthesis and cell-cycle arrest reduces methotrexate cytotoxicity.
What to do
Follow protocol sequencing, giving pegaspargase well before methotrexate or shortly after it. Monitor for hepatotoxicity and methotrexate clearance.
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 Pegaspargase
- Etodolac + Pegaspargase Major
- Ketorolac + Pegaspargase Major
- Mefenamic acid + Pegaspargase Major
- Acetylsalicylic acid + Pegaspargase Moderate
- Argatroban + Pegaspargase Moderate
- Celecoxib + Pegaspargase Moderate
Frequently asked questions
Can I take Methotrexate with Pegaspargase?
MediHelp rates the interaction as moderate. Methotrexate and Pegaspargase 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. Asparaginase depletes asparagine and inhibits protein synthesis, which can blunt methotrexate activity in cells that depend on cell-cycle progression. Sequence of administration therefore influences efficacy and toxicity.
How serious is the interaction between Methotrexate and Pegaspargase?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Follow protocol sequencing, giving pegaspargase well before methotrexate or shortly after it. Monitor for hepatotoxicity and methotrexate clearance.
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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