Compatibility «Methotrexate» and «Arava»

• Interactions Methotrexate with Arava

  • Dangerous interactions
    • ⓘ Other drugs that cause inhibition of bone marrow function or radiation therapy potentiate the effect and additively inhibit bone marrow function.
    • ⓘ Methotrexate in combination with leflunomide may increase the risk of pancytopenia.
    • ⓘ Therefore, patients receiving methotrexate and other potentially hepatotoxic drugs together (for example, leflunomide, azathioprine, sulfasalazine, retinoids) should be closely monitored due to a possible increased risk of hepatotoxicity.
    • ⓘ Since therapy of this kind can lead to the development of additional or even synergistic toxicity (for example, hepatotoxicity or hematotoxicity), the combination of this drug with other basic drugs (for example, methotrexate) is undesirable.
  • Negative interactions
    • ⓘ Simultaneous use of triamterene and methotrexate causes inhibition of bone marrow function and folic acid (folate) deficiency.
    • ⓘ An increase in side effects may occur when taking leflunomide and hepatotoxic compounds together.
    • ⓘ With hepatotoxic drugs and substances (including ethanol) or hematotoxic and immunosuppressive drugs.
    • ⓘ An increase in side effects may occur in the case of recent or concomitant use of hepatotoxic drugs and substances (including ethanol) or hematotoxic and immunosuppressive drugs, or when taking these drugs begins after treatment with leflunomide without a 'laundering' procedure (see the section 'Special instructions').
    • ⓘ Therefore, although, in general, there is no need for a waiting period when switching from taking leflunomide to taking methotrexate, careful monitoring of the activity of 'liver' enzymes in the blood during the initial treatment phase after transferring the patient from taking leflunomide to taking methotrexate is recommended.
    • ⓘ Therefore, caution is recommended when using OAT3 substrates such as cefaclor, benzylpenicillin, ciprofloxacin, furosemide, zidovudine, indomethacin, ketoprofen, cimetidine, methotrexate at the same time.
    • ⓘ For other BCRP substrates (e.g., methotrexate, topotecan, sulfasalazine, daunorubicin, doxorobicin) and the family of organic anion transporter protein (OATR) substrates, especially HMG-CoA reductase inhibitors (e.g., simvastatin, atorvastatin, pravastatin, methotrexate, nateglinide, repaglinide, rifampicin), caution should also be exercised when used together.
  • No interactions
    • ⓘ In 30 patients, the combined intake of leflunomide (100 mg /day for 2 days, then 10-20 mg / day) and methotrexate (10-25 mg / week with folic acid) showed no pharmacokinetic interaction between the drugs.
    • ⓘ In a small study (n=30), with the combined use of leflunomide and methotrexate, 5 out of 30 patients experienced 2-3-fold increases in liver enzyme activity.
    • ⓘ Although pharmacokinetic interaction of A771726 with BCRP (rosuvastatin) substrates has been observed (see below), in 12 patients, there was no pharmacokinetic interaction between leflunomide (10-20 mg per day) and methotrexate (BCRP substrate; 10-25 mg per week).
  • Unclear interactions
    • ⓘ Leflunomide.
    • ⓘ Methotrexate.
    • ⓘ Hepatotoxic drugs.
    • ⓘ With methotrexate.
    • ⓘ In some (5 out of 30) patients with rheumatoid arthritis, while taking leflunomide (10-20 mg per day) and methotrexate (10-25 mg per week), there was a 2-3‑fold increase in the activity of 'liver' enzymes in the blood, and in other 5 patients there was more than a 3-fold increase in activity 'liver' enzymes in the blood.
    • ⓘ Except methotrexate, see above).

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 170,027,037 possible combinations of drugs and their components were found 412,563 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2026-01-01

Category - medicine