Drug interactions
Methotrexate + Sofosbuvir / velpatasvir
Severity: Moderate
Methotrexate and Sofosbuvir / velpatasvir: 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
Velpatasvir inhibits BCRP and may raise methotrexate exposure. Higher levels could cause more myelosuppression and mucosal toxicity.
What this interaction means in plain words
Methotrexate and Sofosbuvir / velpatasvir 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.
Why it happens
Velpatasvir inhibition of intestinal BCRP efflux increases methotrexate absorption.
What to do
Monitor blood counts and liver tests during the combination. Reduce the methotrexate dose if toxicity is seen.
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
Frequently asked questions
Can I take Methotrexate with Sofosbuvir / velpatasvir?
MediHelp rates the interaction as moderate. Methotrexate and Sofosbuvir / velpatasvir 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. Velpatasvir inhibits BCRP and may raise methotrexate exposure. Higher levels could cause more myelosuppression and mucosal toxicity.
How serious is the interaction between Methotrexate and Sofosbuvir / velpatasvir?
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 counts and liver tests during the combination. Reduce the methotrexate dose if toxicity is seen.
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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