藥物交互作用
Amoxicillin + Methotrexate
嚴重程度: 嚴重
Amoxicillin and Methotrexate: major interaction.
最後更新 來源: US FDA label
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摘要
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.
用白話說明這項交互作用的意義
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.
為什麼會發生
Penicillins compete with methotrexate for renal tubular secretion via organic anion transporters, reducing its elimination.
處置方式
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.
可向藥師詢問的問題
- 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?
參考資料
Methotrexate 的其他交互作用
Amoxicillin 的其他交互作用
常見問題
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.
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