INFO - RxList: MTX and antibiotics

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Excerpt:

" Methotrexate is partially bound to serum albumin, and toxicity may be

increased because of displacement by certain drugs, such as

salicylates, phenylbutazone, phenytoin, and sulfonamides. Renal

tubular transport is also diminished by probenecid; use of

methotrexate with this drug should be carefully monitored. Oral

antibiotics such as tetracycline, chloramphenicol, and nonabsorbable

broad spectrum antibiotics, may decrease intestinal absorption of

methotrexate or interfere with the enterohepatic circulation by

inhibiting bowel flora and suppressing metabolism of the drug by

bacteria.

Penicillins may reduce the renal clearance of methotrexate; increased

serum concentrations of methotrexate with concomitant hematologic and

gastrointestinal toxicity have been observed with high and low dose

methotrexate. Use of methotrexate with penicillins should be carefully

monitored. "

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