相互作用
Amoxicillin + Methotrexate
重症度: 重大
Amoxicillin and Methotrexate: major interaction.
最終更新日 出典: US FDA label
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概要
Penicillins such as amoxicillin can reduce methotrexate clearance and have been reported to raise methotrexate levels, causing myelosuppression and mucositis. The effect is mainly reported with high-dose methotrexate and in renal impairment, and is less predictable with low-dose therapy. Evidence is based on case reports and pharmacokinetic observations.
この相互作用をわかりやすく説明すると
Amoxicillin and Methotrexate can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amoxicillin belongs to Anti Bacterial; Methotrexate belongs to Oncology.
なぜ起こるのか
Penicillins compete with methotrexate for renal tubular secretion via organic anion transporters, reducing its elimination.
対処法
Where possible choose an antibiotic with less renal interaction potential, particularly during high-dose methotrexate. If amoxicillin is needed, monitor full blood count, renal function and methotrexate levels where available.
薬剤師に尋ねること
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+会員向け
ページ全体を見る
アカウントを作成してPro+トライアルを始めると、AmoxicillinとMethotrexateの臨床対応の詳細なアドバイス、追加の注記、エビデンスの詳細、処方全体を対象とした相互作用チェッカーを利用できます。
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
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参考文献
Methotrexateのその他の相互作用
Amoxicillinのその他の相互作用
よくある質問
Can I take Amoxicillin with Methotrexate?
MediHelp rates the interaction as major. Amoxicillin and Methotrexate can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Penicillins such as amoxicillin can reduce methotrexate clearance and have been reported to raise methotrexate levels, causing myelosuppression and mucositis. The effect is mainly reported with high-dose methotrexate and in renal impairment, and is less predictable with low-dose therapy. Evidence is based on case reports and pharmacokinetic observations.
How serious is the interaction between Amoxicillin and Methotrexate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Where possible choose an antibiotic with less renal interaction potential, particularly during high-dose methotrexate. If amoxicillin is needed, monitor full blood count, renal function and methotrexate levels where available.
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.
完全なモノグラフ、用量、相互作用チェッカーはMediHelpアプリで
MediHelpアプリで、完全なリファレンスを開き、複数薬剤の相互作用をチェックし、用量ツールを利用できます。
