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Methotrexate and terbinafine

Authoring team

Liver toxicity

  • taking methotrexate and terbinafine together can increase the risk of liver toxicity

Suggested management options (1):

  • routine monitoring of methotrexate should detect any signs of liver toxicity
  • 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 terbinafine
    • restart methotrexate once they feel better.

Reference:

  1. NHS Specialist Pharmacy Service (June 30th 2025). Managing interactions with methotrexate

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