Maxtrex

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

The following medicines should be avoided in people receiving methotrexate:

co-trimoxazole

trimethoprim

nitrous oxide.

Salicylate medicines such as aspirin, and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, ketoprofen and diclofenac can reduce the removal of methotrexate from the body. This can cause levels of methotrexate can build up in the blood, increasing the risk of side effects. For this reason, people taking methotrexate should avoid buying aspirin or NSAIDs such as ibuprofen to take as painkillers or anti-inflammatories. These medicines should only be used on the advice of the doctor who is monitoring your methotrexate treatment, so that changes can be made to your methotrexate dose if necessary.

The following medicines may also decrease the removal of methotrexate from the body and combined use with methotrexate should be well monitored by your doctor:

penicillins

probenecid

retinoids, eg acitretin (there may also be an increased risk of side effects on the liver with this combination)

sulphonamides, eg sulphamethoxazole

tetracycline.

Vaccines may be less effective in people taking this medicine. This is because methotrexate reduces the activity of the immune system and can prevent the body forming adequate antibodies. Live vaccines should be avoided where possible because they may cause infection. Live vaccines include the following: oral polio; rubella; measles, mumps and rubella (MMR); BCG; yellow fever and oral typhoid vaccines.

Check with your doctor before taking vitamin preparations that contain folic acid while you are taking methotrexate.

Other medicines containing the same active ingredient

Methotrexate tablets are also available without a brand name, ie as the generic medicine.

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