Drug interactions
Methotrexate + Vancomycin
Severity: Minor
Methotrexate and Vancomycin: minor 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
The link between vancomycin and methotrexate is poorly established. Vancomycin can cause kidney injury, which would delay methotrexate excretion, but oral vancomycin is minimally absorbed.
What this interaction means in plain words
Methotrexate and Vancomycin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Methotrexate belongs to Oncology; Vancomycin belongs to Anti Bacterial.
Why it happens
Potential reduced methotrexate clearance if intravenous vancomycin causes nephrotoxicity; no well-established direct mechanism.
What to do
Monitor renal function and methotrexate levels when giving intravenous vancomycin with methotrexate, particularly at high doses. Adjust the methotrexate dose if kidney function worsens.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Methotrexate and Vancomycin, 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.
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 Vancomycin
- Amikacin + Vancomycin Major
- Bacitracin + Vancomycin Major
- Capreomycin + Vancomycin Major
- Cephaloridine + Vancomycin Major
- Cidofovir + Vancomycin Major
- Cisplatin + Vancomycin Major
Frequently asked questions
Can I take Methotrexate with Vancomycin?
MediHelp rates the interaction as minor. Methotrexate and Vancomycin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. The link between vancomycin and methotrexate is poorly established. Vancomycin can cause kidney injury, which would delay methotrexate excretion, but oral vancomycin is minimally absorbed.
How serious is the interaction between Methotrexate and Vancomycin?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor renal function and methotrexate levels when giving intravenous vancomycin with methotrexate, particularly at high doses. Adjust the methotrexate dose if kidney function worsens.
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.
