Adverse effects are caused by the antibiotic's ability to reduce methotrexate absorption in the body. When the absorption rate is slowed, it can lead to a buildup of the medication in the body over time and cause toxicity.
Some other antibiotic medications that should not be taken with methotrexate include:. You should also avoid getting immunized with live vaccines while using methotrexate. Speak to your healthcare provider about any possible immunizations you can and cannot receive.
If you experience liver problems, unusual bleeding, kidney problems, or signs of tumor lysis syndrome , call your healthcare provider immediately. Taking methotrexate and some medications will pose a moderate risk of drug interactions. These interactions are not as dangerous as those above, but they do pose health risks. Since low doses of methotrexate are typically used to treat inflammatory arthritis like RA, the interaction with NSAIDS is typically not clinically significant.
Some NSAIDs can be used under direct supervision in people who take low-dose methotrexate, including:. Taking methotrexate with some mental disorder medications can pose a moderate risk for adverse health effects. The antipsychotic medications that increase the risk for adverse effects are those that affect the liver.
One such medication is chlorpromazine. Another medication that can increase the risk for liver toxicity is duloxetine Cymbalta. People with diabetes are often at an increased risk of liver disease and infection, and the use of methotrexate together with some diabetes medications may increase that risk even further.
Using methotrexate over a long period of time has also been linked to liver conditions such as cirrhosis. Specific medications that should be avoided or used with caution include:. For those taking diuretics , methotrexate may pose a moderate risk because methotrexate may hinder the actions of the diuretic medication, diminishing its therapeutic effect. Some specific diuretics that you should look out for when taking or starting methotrexate include:.
Methotrexate has been reported as a seizure inducer and should be avoided by most on antiepileptic drugs. Some antiepileptic medications have been shown to reduce how well methotrexate works. Some specific seizure medications that should not be taken with methotrexate include:. Some medications can be taken safely with methotrexate and may cause only minor effects. When used in conjunction with methotrexate, many immunosuppressants should be avoided.
However, some are safe to use. For example, azathioprine Imuran, Azasan is an immunosuppressant that can be taken with methotrexate safely and effectively. Anticonvulsants that are safe to take while on methotrexate include:. Although many NSAIDs should not be taken with methotrexate because of the increased risk of liver toxicity, tromethamine Tham is one that can be safely taken with only a small risk of increasing the natural side effects of methotrexate alone.
Some people who take methotrexate will need to take folic acid supplements because the medication can diminish the amount of folate in the body.
Methotrexate causes the body to waste more of the nutrient than it normally would, causing a deficiency. Speak to your healthcare provider about whether you should be taking folic acid to prevent the deficiency before supplementing on your own. When it comes to methotrexate, some foods or nutritional supplements can lead to adverse health effects or worsen the existing side effects of the drug.
There is some debate about whether caffeine poses a moderate risk of adverse effects when taking methotrexate. Examples include a group of prescription and over-the-counter pain medicines called nonsteroidal anti-inflammatory drugs NSAIDs , such as Motrin or Advil ibuprofen ; a group of medicines used to treat stomach acid associated with gastric reflux or stomach ulcers; and certain antibiotics.
A serious reaction can occur because these medicines increase the toxic effects of methotrexate. When one medicine affects another medicine, it is called a drug-drug interaction. Two fatal events caused by drug-drug interactions with low-dose methotrexate were recently reported. The man was also taking the antibiotic amoxicillin to treat an infection. The next day, his doctor also gave him a prescription for leflunomide, another medicine to treat rheumatoid arthritis.
Within a week, the man was hospitalized with a very low blood count. Despite all efforts to treat him, the man died. In the other case, an elderly man with rheumatoid arthritis was hospitalized with a fractured leg caused by a fall. While in the hospital, his weekly dose of methotrexate 20 mg was continued. He was also receiving a pain medicine, diclofenac, as needed every 6 hours.
The man developed kidney failure and extremely low blood counts, and died. Even when low-dose methotrexate is taken correctly, severe side effects can occur that can lead to hospitalization or death. Methotrexate primarily affects the blood cell counts causing them to become low.
Your doctor will only prescribe methotrexate for you while you're pregnant if the benefits of the medicine outweigh the chances of it being harmful. If your weekly dose of methotrexate is 25mg or less, it may be possible to breastfeed. However, you must not breastfeed for 24 hours after taking your medicine. Your midwife or health visitor can give you advice about how to feed your baby while you wait 24 hours.
You may still be able to breastfeed if your doctor says it is OK. However it depends on your dose of methotrexate and any other medicines you are taking. If you breastfeed while taking methotrexate, your baby will have blood tests to check for any side effects.
If you notice that your baby isn't feeding as well as usual, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible. For more information about how this medicine could affect you and your baby, read the leaflet on methotrexate on the Best Use of Medicines in Pregnancy BUMPs website.
Children taking methotrexate must not have a "live" flu vaccine this usually applies to children aged 2 to 17 years. Adults are given an "inactivated" flu vaccine and this usually does not cause problems with methotrexate. Tell your doctor if you're taking these medicines before you start methotrexate:. Do not take vitamin and mineral supplements or any other products that contain folic acid folate if you are already taking folic acid prescribed by your doctor.
Check the ingredients on the labels of any supplements. There is not enough information to say whether it's safe to take other herbal remedies or supplements together with methotrexate. They are not tested in the same way as medicines. Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
Methotrexate calms your immune system, to help stop it attacking your body's cells. This helps reduce the inflammation that causes swollen and stiff joints in rheumatoid arthritis, thickened skin in psoriasis or damage to your bowel in Crohn's disease.
Methotrexate is not a painkiller. However, by reducing the inflammation caused by the condition, you may notice a reduction in pain as your symptoms improve. When used in cancer treatments, methotrexate stops cancer cells reproducing.
This helps prevent them growing and spreading in your body. Once your dose of methotrexate has been increased to a full dose, it may take up to 12 weeks before you notice any benefits.
It's important to keep taking methotrexate. The medicine is working, even if you do not feel any different for a few months. If methotrexate works for you, you may need to take it for several years to control your symptoms. Methotrexate may increase the risk of problems with your liver or lungs, especially if you take a high dose. However, your doctor will monitor you very closely while you're taking methotrexate. Any concerns or problems will be found during routine check-ups.
Speak to your doctor or specialist nurse if you are worried about taking methotrexate. There is no evidence that methotrexate increases the risk of developing cervical cancer. When you start your treatment, your hospital consultant will usually give you the first few prescriptions for methotrexate.
You will get 1 week's supply at a time. They will monitor you closely to make sure that the medicine is working properly, the dose is at the correct level and not giving you too many side effects. Once the dose is right and your condition is stable, the consultant may ask your GP to continue your treatment. Your GP will also decide where you'll go for blood tests and how often. Once this is agreed, and if your blood results are OK, your GP will usually give you 1 month's supply of methotrexate at a time or 4 doses.
Methotrexate may lower the number of white cells in your blood. This can make you more likely to get an infection. It's important to reduce your risk of getting an infection. When possible, avoid close contact with people who you know are unwell. Tell your doctor if you think you are getting a sore throat or if you have a high temperature.
There are several different treatments that can help the symptoms of inflammatory conditions. These include medicines, other types of therapy and even surgery. Your doctor will be able to recommend the best treatment for you, based on your condition and your symptoms. It's usually OK to drink alcohol if you take a low weekly dose of methotrexate 25mg or less for the long-term treatment of an inflammatory condition.
If you are taking high doses of methotrexate, ask your doctor for advice about drinking alcohol. The risk of an interaction seems greatest with high-dose methotrexate eg, mg or more daily to treat neoplastic disease and in patients with impaired renal function. The advice of the Committee on Safety of Medicines CSM; incorporated into the Commission on Human Medicines in is that any patient prescribed low-dose methotrexate alone should have a full blood count and renal and liver function tests before starting treatment.
These tests should be repeated weekly until therapy is stabilised, and every two to three months thereafter. Their advice regarding prescribed ibuprofen and other NSAIDs is that the methotrexate should be well monitored, which implies that the monitoring should be more frequent. It should be noted, however, that both the CSM guidance and the manufacturers advise against the use of azapropazone or non-prescription ibuprofen with low-dose methotrexate therapy.
0コメント