This fact sheet has been written for parents and carers about how to use this medicine in children. This information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this information carefully and keep it somewhere safe so that you can read it again.
Methotrexate is used to treat a wide range of cancers. High dose methotrexate is given in hospital as an intravenous infusion and this information sheet is NOT referring to intermediate dose methotrexate (capizzi), intrathecal methotrexate or methotrexate tablets administered at home.
Interactions with other medications
Methotrexate can interact with other medications, especially when given in high doses. For example, the following medications may affect the levels of methotrexate in the body:
- Some antibiotics including penicillins (e.g. Amoxycillin, Flucloxacillin), trimethoprim with sulfamethoxazole (also called Septrin, Resprim and Bactrim) and ciprofloxacin.
- Proton pump inhibitors given to protect the stomach (e.g. Omeprazole, Esomeprazole, Pantoprazole).
- Some medicines used to treat pain and inflammation (Non-Steroidal Anti-inflammatory Drugs NSAIDs) such as Ibuprofen – Nurofen/Brufen/Advil , and Diclofenac – Voltaren.
- Other medicines including Levetiracetam (Keppra) and other medicines used to prevent seizures. It is important NOT to stop medicines like Levetiracetam abruptly. Please discuss a plan for your child with your consultant.
These medications can reduce the body’s ability to excrete/remove methotrexate from the blood which may result in a higher chance of side effects/toxicity.