Drug interactions
Methotrexate + Ponesimod
Severity: Moderate
Methotrexate and Ponesimod: 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
Ponesimod lowers circulating lymphocytes and methotrexate is immunosuppressive, so the combination may raise the risk of infection. The effect can persist for weeks after stopping ponesimod.
What this interaction means in plain words
Methotrexate and Ponesimod 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; Ponesimod belongs to Central Nervous System.
Why it happens
Additive immunosuppression from lymphocyte sequestration and antimetabolite activity.
What to do
Monitor for infection and check blood counts and lymphocyte counts. Take the prolonged effects of each drug into account when switching therapies.
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 Ponesimod
- Fingolimod + Ponesimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Amiodarone + Ponesimod Major
- Amisulpride + Ponesimod Major
- Anagrelide + Ponesimod Major
- Anti-thymocyte + Ponesimod Major
Frequently asked questions
Can I take Methotrexate with Ponesimod?
MediHelp rates the interaction as moderate. Methotrexate and Ponesimod 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. Ponesimod lowers circulating lymphocytes and methotrexate is immunosuppressive, so the combination may raise the risk of infection. The effect can persist for weeks after stopping ponesimod.
How serious is the interaction between Methotrexate and Ponesimod?
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 for infection and check blood counts and lymphocyte counts. Take the prolonged effects of each drug into account when switching therapies.
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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