What Are the Different Methotrexate Interactions?

Methotrexate is a medication that is used to treat a variety of conditions caused by abnormally rapid cell growth, such as psoriasis, in which skin cells don’t shed normally and accumulate into thick patches, and cancer, in which abnormal cells build up and affect the functioning of normal cells. The medication is thought to be effective at treating these types of conditions by slowing down the production of the body’s cells. Due to the numerous methotrexate interactions with other drugs that tend to occur, the medication is usually only prescribed if other medications were found to not be effective.

One of the more mild and common methotrexate interactions is with NSAIDs such as naproxen and ibuprofen, and salicylates, such as aspirin. NSAIDs and salicylates are generally over-the-counter drugs that are used primarily to treat pain and inflammation. When either of these drugs is taken in conjunction with methotrexate, they may cause the effects of methotrexate to increase. The main potentially serious complication that may occur with these increased effects is kidney malfunction, which can lead to kidney failure and eventually death if left untreated.

Another widely used medication that may cause methotrexate interactions are certain forms of antibiotics, particularly those that are penicillin-based. Antibiotics are typically prescribed to rid the body of bacterial infections. If antibiotics are taken with methotrexate, it may also interfere with kidney function; therefore, if an infection is present in a patient, other treatment options, such as using a different antibiotic or finding a substitute for methotrexate, will generally be recommended.

People with diabetes tend to be at a higher risk of developing methotrexate interactions, so the medication is often either not recommended unless other effective alternatives are not available. Many diabetes medications, such as glimepiride and chlorpropamide, help treat the condition by causing the pancreas to produce more insulin, a hormone that aids the body in using glucose as an energy source for helping body parts, such as the liver, function properly. Combining diabetes medications with methotrexate can cause either of the medication levels to increase and may result in damage to the liver.

Medications used to treat acne may potentially cause complications if they are taken with methotrexate. Retinol, a form of vitamin A, is a medication that may be recommended in the treatment of mild to moderate acne and can increase the potency of methotrexate. Isotretinoin, a prescription medication used for the treatment of severe acne, may also interact with methotrexate and cause either medication to spike to potentially dangerously high levels. Both the skin medications and methotrexate may make the skin more sensitive to sunlight, so taking them together may lead to sun burns and make existing skin conditions worsen.