Drug interactions
Methotrexate + Varicella virus vaccine live
Severity: Contraindicated
Methotrexate and Varicella virus 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 varicella vaccine may cause disseminated vaccine-strain varicella in patients on methotrexate. Antibody response may also be reduced.
What this interaction means in plain words
Methotrexate and Varicella virus 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 suppresses T-cell and B-cell function, permitting replication of the attenuated virus.
What to do
Avoid during methotrexate therapy; check immunity beforehand and vaccinate at least 4 weeks before starting when possible. Specialist advice is needed for borderline low-dose cases.
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?
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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 Varicella virus vaccine live?
MediHelp rates the interaction as contraindicated. Methotrexate and Varicella virus 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 varicella vaccine may cause disseminated vaccine-strain varicella in patients on methotrexate. Antibody response may also be reduced.
How serious is the interaction between Methotrexate and Varicella virus 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 during methotrexate therapy; check immunity beforehand and vaccinate at least 4 weeks before starting when possible. Specialist advice is needed for borderline low-dose cases.
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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