Drug interactions
Methotrexate + Tretinoin
Severity: Moderate
Methotrexate and Tretinoin: 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
Systemic retinoids and methotrexate can each injure the liver, so using them together raises the risk of hepatotoxicity. Topical tretinoin has minimal systemic absorption, making a meaningful interaction unlikely with that form.
What this interaction means in plain words
Methotrexate and Tretinoin 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; Tretinoin belongs to Dermatology.
Why it happens
Additive hepatotoxicity of two agents that are each hepatically toxic.
What to do
If oral tretinoin is used with methotrexate, monitor liver enzymes regularly and stop one agent if they rise significantly. No special action is needed for topical tretinoin.
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 Tretinoin
- Doxycycline + Tretinoin Major
- Minocycline + Tretinoin Major
- Omadacycline + Tretinoin Major
- Palovarotene + Tretinoin Major
- Sarecycline + Tretinoin Major
- Tetracycline + Tretinoin Major
Frequently asked questions
Can I take Methotrexate with Tretinoin?
MediHelp rates the interaction as moderate. Methotrexate and Tretinoin 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. Systemic retinoids and methotrexate can each injure the liver, so using them together raises the risk of hepatotoxicity. Topical tretinoin has minimal systemic absorption, making a meaningful interaction unlikely with that form.
How serious is the interaction between Methotrexate and Tretinoin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: If oral tretinoin is used with methotrexate, monitor liver enzymes regularly and stop one agent if they rise significantly. No special action is needed for topical tretinoin.
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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