Lansoprazole and Methotrexate: Drug Interaction Guide

Quick answer: This combination requires caution. Lansoprazole and Methotrexate can be used together with adjustments and monitoring.

Interaction severity: Moderate — caution required

How Lansoprazole interacts with Methotrexate

Proton pump inhibitors reduce renal tubular secretion of methotrexate and its metabolites, prolonging exposure and increasing the risk of myelotoxicity and mucositis.

What you should do

Withhold PPIs around high-dose methotrexate cycles and substitute an H2 antagonist or sucralfate; monitor methotrexate clearance and full blood count.

Key facts

Severity

Moderate — caution required

Mechanism

Proton pump inhibitors reduce renal tubular secretion of methotrexate and its metabolites, prolonging exposure and incre...

Action

Withhold PPIs around high-dose methotrexate cycles and substitute an H2 antagonist or sucralfate; monitor methotrexate c...

Important medical disclaimer: This page provides educational information about drug interactions for general reference. It is not a substitute for professional medical advice, diagnosis, or treatment. Always discuss your specific medications with a qualified healthcare provider before starting, stopping, or changing any treatment. About our editorial team.

Frequently asked questions

Can I take Lansoprazole and Methotrexate together?

With caution. Withhold PPIs around high-dose methotrexate cycles and substitute an H2 antagonist or sucralfate; monitor methotrexate clearance and full blood count.

What is the severity of this interaction?

The interaction between Lansoprazole and Methotrexate is classified as Moderate — caution required. Proton pump inhibitors reduce renal tubular secretion of methotrexate and its metabolites, prolonging exposure and increasing the risk of myelotoxicity and mucositis.

What should I do if I'm prescribed both?

Withhold PPIs around high-dose methotrexate cycles and substitute an H2 antagonist or sucralfate; monitor methotrexate clearance and full blood count. Always consult your prescribing clinician — do not stop or change medications without medical guidance.

Last reviewed: by iMedic Medical Editorial Team. Our editorial process.