Methotrexate and penicillins
Methotrexate toxicity
- penicillins (for example, amoxicillin) may reduce the clearance of methotrexate via the kidneys by competitive inhibition
- leads to an increased the risk of methotrexate toxicity
Suggested management options (1):
- if the duration of penicillin is short (up to 10 days), consider using with caution and advise to monitor for signs of toxicity (for example, sore throat, bruising and bleeding)
- In the presence of a severe acute or chronic infection, some people on stable methotrexate therapy can miss doses of methotrexate whilst taking the course of penicillin antibiotics
- restart methotrexate once they feel better
Reference:
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