Drug interactions
methotrexate (high-dose) + proton pump inhibitors (e.g., omeprazole)
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.
Overview
↑ MTX exposure → toxicity.
Mechanism of action
Reduced renal tubular secretion.
Clinical management
Avoid PPI around HD-MTX; switch to H2 blocker.
References
- methotrexate (high-dose)+proton pump inhibitors (e.g., omeprazole) interaction (SPS search) — SPS
- methotrexate (high-dose)+proton pump inhibitors (e.g., omeprazole) interaction (PubMed search) — PubMed
- methotrexate (high-dose)+proton pump inhibitors (e.g., omeprazole) labeling (DailyMed search) — DailyMed
Frequently asked questions
Can I take methotrexate (high-dose) with proton pump inhibitors (e.g., omeprazole)?
The interaction is rated: Major. ↑ MTX exposure → toxicity.
How serious is the interaction between methotrexate (high-dose) and proton pump inhibitors (e.g., omeprazole)?
The interaction is rated: Major. Evidence level: Moderate.
How is the interaction between methotrexate (high-dose) and proton pump inhibitors (e.g., omeprazole) managed?
Avoid PPI around HD-MTX; switch to H2 blocker.
Why do methotrexate (high-dose) and proton pump inhibitors (e.g., omeprazole) interact?
Reduced renal tubular secretion.
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.