Drug interactions
Methotrexate + Smallpox vaccine live
Severity: Contraindicated
Methotrexate and Smallpox vaccine live: contraindicated 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 vaccinia vaccine can cause progressive vaccinia and serious generalized infection in immunosuppressed patients taking methotrexate. Vaccine response may also be impaired.
What this interaction means in plain words
Methotrexate and Smallpox vaccine live are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Methotrexate impairs cellular immunity needed to contain vaccinia virus replication.
What to do
Avoid the replicating vaccinia vaccine during methotrexate therapy; use a non-replicating alternative vaccine if protection is required.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Methotrexate and Smallpox vaccine live, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Smallpox vaccine live?
MediHelp rates the interaction as contraindicated. Methotrexate and Smallpox vaccine live are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Live vaccinia vaccine can cause progressive vaccinia and serious generalized infection in immunosuppressed patients taking methotrexate. Vaccine response may also be impaired.
How serious is the interaction between Methotrexate and Smallpox vaccine live?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the replicating vaccinia vaccine during methotrexate therapy; use a non-replicating alternative vaccine if protection is required.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
