Drug interactions
Methotrexate + Pretomanid
Severity: Major
Methotrexate and Pretomanid: major interaction.
Last updated Sources: US FDA label
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
The pretomanid regimen is associated with hepatotoxicity, and methotrexate is also hepatotoxic. Together they may raise the risk of liver injury.
What this interaction means in plain words
Methotrexate and Pretomanid 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; Pretomanid belongs to Anti Bacterial.
Why it happens
Additive hepatotoxicity; no pharmacokinetic mechanism is established.
What to do
Avoid methotrexate during pretomanid-based therapy where possible. If it cannot be avoided, check liver enzymes frequently.
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?
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References
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 Pretomanid
Frequently asked questions
Can I take Methotrexate with Pretomanid?
MediHelp rates the interaction as major. Methotrexate and Pretomanid 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. The pretomanid regimen is associated with hepatotoxicity, and methotrexate is also hepatotoxic. Together they may raise the risk of liver injury.
How serious is the interaction between Methotrexate and Pretomanid?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid methotrexate during pretomanid-based therapy where possible. If it cannot be avoided, check liver enzymes frequently.
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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