Can methotrexate affect other medications and treatments?
Methotrexate may be prescribed along with other drugs to treat your condition. Some drugs however, can interact with methotrexate. Check with your doctor before starting any new medications, and remember to mention you're on methotrexate if you're treated by anyone other than your usual rheumatology team.
- You can carry on taking a non-steroidal anti-inflammatory drug (NSAID) or painkillers if needed, unless your doctor advises otherwise.
- Don't take over-the-counter preparations or herbal remedies without discussing this first with your healthcare team.
- Some antibiotics can interact with methotrexate – for example, trimethoprim and septrin should not be taken with methotrexate. If you have an infection that requires antibiotics you may need to stop your methotrexate until you are better and off antibiotics.
- Anti-epileptic medication (phenytoin) and anti-asthma medication (theophylline) should be avoided as they may increase levels of methotrexate in your blood. However, it's important that you discuss this with your rheumatology team and that you don't simply stop your phenytoin.
Can I have vaccinations if I'm on methotrexate?
If you're on methotrexate it's recommended that you avoid live vaccines such as yellow fever. Your GP will discuss the possible risks and benefits of any vaccinations with you.
If you're offered a shingles vaccination you should speak to your rheumatology team – you may be able to have the shingles vaccine if you are on low-dose methotrexate.
Pneumococcal vaccine (which gives protection against the commonest cause of pneumonia) and yearly flu vaccines don't interact with methotrexate and are recommended.