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Drug interactions

Methotrexate + Ponatinib

Severity: Moderate

Methotrexate and Ponatinib: 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

Ponatinib may inhibit BCRP and P-gp and could raise methotrexate exposure. This could heighten the risk of myelosuppression and mucosal or hepatic toxicity.

What this interaction means in plain words

Methotrexate and Ponatinib 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; Ponatinib belongs to Oncology.

Evidence level: Low

Why it happens

Possible inhibition of BCRP and P-gp efflux transporters by ponatinib raises methotrexate concentrations.

What to do

Monitor blood counts, liver enzymes and renal function. Lower the methotrexate dose if signs of toxicity 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Methotrexate with Ponatinib?

MediHelp rates the interaction as moderate. Methotrexate and Ponatinib 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. Ponatinib may inhibit BCRP and P-gp and could raise methotrexate exposure. This could heighten the risk of myelosuppression and mucosal or hepatic toxicity.

How serious is the interaction between Methotrexate and Ponatinib?

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, liver enzymes and renal function. Lower the methotrexate dose if signs of toxicity develop.

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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