Taking methotrexate with other medicines and herbal supplements - Brand names: Jylamvo, Maxtrex, Methofill, Metoject, Nordimet, Zlatal

Cautions with other medicines

There are many medicines that affect the way methotrexate works.

Always show your patient card to healthcare professionals who may not know about your methotrexate treatment to alert them about your once weekly dose. For example, if you go to hospital or have a change in your care.

Children taking methotrexate must not have a live children's 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 any of these medicines before you start taking methotrexate:

• non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, or cough and cold remedies containing NSAIDs
• co-trimoxazole, trimethoprim or other antibiotics for bacterial infections
• medicines that make you pee more (diuretics), such as indapamide or bendroflumethiazide
• epilepsy medicines such as phenytoin or levetiracetam
• theophylline, a medicine used to treat asthma
• medicines used to treat indigestion, such as omeprazole
• folic acid or vitamin supplements that contain folic acid (or folate) – this is because your doctor may prescribe folic acid to take with your methotrexate

These are not all the medicines that may affect methotrexate. Check the leaflet that comes with your medicine.

Mixing methotrexate with herbal remedies and supplements

Do not take vitamin and mineral supplements or any other products that contain folic acid (folate) if you're already taking folic acid prescribed by your doctor. Check the ingredients on the labels of any supplements.

There's not enough information to say whether it's safe to take other herbal remedies or supplements together with methotrexate. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.