Drug interactions
Methotrexate + Rotavirus oral vaccine live
Severity: Major
Methotrexate and Rotavirus oral vaccine live: major interaction.
Last updated Sources: UK SmPC
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
Live rotavirus vaccine may cause prolonged vaccine-virus infection in immunosuppressed individuals, including infants exposed to methotrexate. This is chiefly relevant to infants of mothers treated in pregnancy or breastfeeding, or to children on methotrexate.
What this interaction means in plain words
Methotrexate and Rotavirus oral vaccine live 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.
Why it happens
Immunosuppression by methotrexate reduces control of the replicating attenuated virus.
What to do
Avoid in children receiving immunosuppressive methotrexate doses and seek specialist advice. For infants with in-utero exposure, follow national immunization guidance on timing.
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
- Jylamvo 2 mg/ml oral solution - SmPC sections 4.3/4.5 (class statement: live vaccines; "Concurrent vaccination with live vaccines") — electronic medicines compendium (UK SmPC)
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
Frequently asked questions
Can I take Methotrexate with Rotavirus oral vaccine live?
MediHelp rates the interaction as major. Methotrexate and Rotavirus oral vaccine live 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. Live rotavirus vaccine may cause prolonged vaccine-virus infection in immunosuppressed individuals, including infants exposed to methotrexate. This is chiefly relevant to infants of mothers treated in pregnancy or breastfeeding, or to children on methotrexate.
How serious is the interaction between Methotrexate and Rotavirus oral vaccine live?
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 in children receiving immunosuppressive methotrexate doses and seek specialist advice. For infants with in-utero exposure, follow national immunization guidance on timing.
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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