Drug interactions
Methotrexate + Sapropterin
Severity: Moderate
Methotrexate and Sapropterin: 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
Methotrexate inhibits dihydrofolate reductase and may also inhibit dihydropteridine reductase, interfering with recycling of tetrahydrobiopterin. This may reduce sapropterin effect on phenylalanine control.
What this interaction means in plain words
Methotrexate and Sapropterin 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; Sapropterin belongs to Miscellaneous.
Why it happens
Inhibition of folate and pteridine reductases by methotrexate impairs biopterin recycling.
What to do
Monitor blood phenylalanine levels when starting or stopping methotrexate. Adjust sapropterin dose according to response.
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 Sapropterin
- Avanafil + Sapropterin Moderate
- Carbidopa-entacapone-levodopa + Sapropterin Moderate
- Carbidopa-levodopa + Sapropterin Moderate
- Levodopa + Sapropterin Moderate
- Phenobarbitone + Sapropterin Moderate
- Pyrimethamine + Sapropterin Moderate
Frequently asked questions
Can I take Methotrexate with Sapropterin?
MediHelp rates the interaction as moderate. Methotrexate and Sapropterin 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 inhibits dihydrofolate reductase and may also inhibit dihydropteridine reductase, interfering with recycling of tetrahydrobiopterin. This may reduce sapropterin effect on phenylalanine control.
How serious is the interaction between Methotrexate and Sapropterin?
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 phenylalanine levels when starting or stopping methotrexate. Adjust sapropterin dose according to response.
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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