Methotrexate and Omeprazole: Drug Interaction Guide
Quick answer: This combination requires caution. Methotrexate and Omeprazole can be used together with adjustments and monitoring.
How Methotrexate interacts with Omeprazole
Proton pump inhibitors reduce renal clearance of methotrexate via inhibition of organic anion transporters, prolonging exposure and increasing toxicity risk especially with high-dose regimens.
What you should do
Hold PPI during high-dose methotrexate therapy; substitute H2-antagonist if acid suppression needed. For low-dose methotrexate, monitor for toxicity.
Key facts
Severity
Moderate — caution required
Mechanism
Proton pump inhibitors reduce renal clearance of methotrexate via inhibition of organic anion transporters, prolonging e...
Action
Hold PPI during high-dose methotrexate therapy; substitute H2-antagonist if acid suppression needed. For low-dose methot...
Frequently asked questions
Can I take Methotrexate and Omeprazole together?
With caution. Hold PPI during high-dose methotrexate therapy; substitute H2-antagonist if acid suppression needed. For low-dose methotrexate, monitor for toxicity.
What is the severity of this interaction?
The interaction between Methotrexate and Omeprazole is classified as Moderate — caution required. Proton pump inhibitors reduce renal clearance of methotrexate via inhibition of organic anion transporters, prolonging exposure and increasing toxicity risk especially with high-dose regimens.
What should I do if I'm prescribed both?
Hold PPI during high-dose methotrexate therapy; substitute H2-antagonist if acid suppression needed. For low-dose methotrexate, monitor for toxicity. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.