Drug Interactions between methotrexate and Skyrizi
This report displays the potential drug interactions for the following 2 drugs:
- methotrexate
- Skyrizi (risankizumab)
Interactions between your drugs
No interactions were found between methotrexate and Skyrizi. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
methotrexate
A total of 696 drugs are known to interact with methotrexate.
- Methotrexate is in the following drug classes: antimetabolites, antipsoriatics, antirheumatics, other immunosuppressants.
-
Methotrexate is used to treat the following conditions:
- Acute Lymphoblastic Leukemia
- Acute Lymphocytic Leukemia
- Acute Nonlymphocytic Leukemia (off-label)
- Bladder Cancer (off-label)
- Brain Tumor (off-label)
- Breast Cancer
- Bullous Pemphigoid (off-label)
- Cervical Cancer (off-label)
- Choriocarcinoma
- Cogan's Syndrome (off-label)
- Colorectal Cancer (off-label)
- Dermatomyositis
- Ectopic Pregnancy (off-label)
- Eczema (off-label)
- Esophageal Carcinoma (off-label)
- Gastric Cancer (off-label)
- Graft-versus-host disease
- Head and Neck Cancer
- Hodgkin's Lymphoma (off-label)
- Lymphoma
- Mantle Cell Lymphoma (off-label)
- Meningeal Leukemia
- Mycosis Fungoides
- Neoplastic Diseases
- Non Small Cell Lung Cancer
- Non-Hodgkin's Lymphoma
- Osteosarcoma
- Ovarian Cancer (off-label)
- Pancreatic Cancer (off-label)
- Pemphigoid (off-label)
- Pemphigus (off-label)
- Pityriasis rubra pilaris (off-label)
- Polyarticular Juvenile Idiopathic Arthritis
- Psoriasis
- Psoriatic Arthritis
- Rheumatoid Arthritis
- Scleroderma (off-label)
- Small Cell Lung Cancer
- Soft Tissue Sarcoma (off-label)
- Solid Tumors
- Systemic Sclerosis
- Trophoblastic Disease
- Uveitis (off-label)
Skyrizi
A total of 164 drugs are known to interact with Skyrizi.
- Skyrizi is in the drug class interleukin inhibitors.
- Skyrizi is used to treat the following conditions:
Drug and food interactions
methotrexate food
Applies to: methotrexate
MONITOR: Limited data suggest that consumption of greater than 180 mg/day of caffeine may interfere with the efficacy of methotrexate (MTX) in patients with rheumatoid arthritis. The exact mechanism of interaction is unknown but may be related to the antagonistic effect of caffeine on adenosine receptors, as anti-inflammatory properties of MTX is thought to result from the accumulation of adenosine. In a study of 39 patients treated with MTX 7.5 mg/week (without folate supplementation) for 3 months, patients with high caffeine intake (more than 180 mg/day) experienced significantly less improvement in morning stiffness and joint pain from baseline than patients with low caffeine intake (less than 120 mg/day). There were no significant differences between the responses of patients with moderate caffeine intake (120 to 180 mg/day) and those of the other 2 groups. In an interview of 91 patients treated with MTX, 26% of patients who discontinued the drug were regular coffee drinkers compared to only 2% of those still receiving the drug. Because treatment failure was the reason for MTX discontinuation in 80% of patients who discontinued, the investigators suggested that caffeine may have interfered with MTX efficacy.
MANAGEMENT: Until further information is available, the potential for interaction should be considered in patients who consume substantial amounts of caffeine and caffeine-containing foods and are prescribed methotrexate for rheumatoid arthritis. It may be appropriate to limit caffeine intake if an interaction is suspected in cases of treatment failure.
References
- Nesher G, Mates M, Zevin S (2003) "Effect of caffeine consumption on efficacy of methotrexate in rheumatoid arthritis." Arthritis Rheum, 48, p. 571-572
methotrexate food
Applies to: methotrexate
GENERALLY AVOID: Coadministration of methotrexate with other agents known to induce hepatotoxicity may potentiate the risk of liver injury. Methotrexate, especially at higher dosages or during prolonged treatment, has been associated with severe hepatotoxicity including acute hepatitis, chronic fibrosis, cirrhosis, and fatal liver failure.
MANAGEMENT: The risk of hepatic injury should be considered when methotrexate is used with other potentially hepatotoxic agents (e.g., acetaminophen; alcohol; androgens and anabolic steroids; antituberculous agents; azole antifungal agents; ACE inhibitors; cyclosporine (high dosages); disulfiram; endothelin receptor antagonists; interferons; ketolide and macrolide antibiotics; kinase inhibitors; minocycline; nonsteroidal anti-inflammatory agents; nucleoside reverse transcriptase inhibitors; proteasome inhibitors; retinoids; sulfonamides; tamoxifen; thiazolidinediones; tolvaptan; vincristine; zileuton; anticonvulsants such as carbamazepine, hydantoins, felbamate, and valproic acid; lipid-lowering medications such as fenofibrate, lomitapide, mipomersen, niacin, and statins; herbals and nutritional supplements such as black cohosh, chaparral, comfrey, DHEA, kava, pennyroyal oil, and red yeast rice). Baseline and periodic monitoring of hepatic function is recommended, while liver biopsy may be warranted during long-term use of methotrexate. Patients should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, itching, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, pale stools, and jaundice.
References
- (2002) "Product Information. Methotrexate (methotrexate)." Lederle Laboratories
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- (2023) "Product Information. Methotrexate (methotrexate)." Hospira Inc
methotrexate food
Applies to: methotrexate
MONITOR: Limited data suggest that consumption of greater than 180 mg/day of caffeine may interfere with the efficacy of methotrexate (MTX) in patients with rheumatoid arthritis. The exact mechanism of interaction is unknown but may be related to the antagonistic effect of caffeine on adenosine receptors, as anti-inflammatory properties of MTX is thought to result from the accumulation of adenosine. In a study of 39 patients treated with MTX 7.5 mg/week (without folate supplementation) for 3 months, patients with high caffeine intake (more than 180 mg/day) experienced significantly less improvement in morning stiffness and joint pain from baseline than patients with low caffeine intake (less than 120 mg/day). There were no significant differences between the responses of patients with moderate caffeine intake (120 to 180 mg/day) and those of the other 2 groups. In an interview of 91 patients treated with MTX, 26% of patients who discontinued the drug were regular coffee drinkers compared to only 2% of those still receiving the drug. Because treatment failure was the reason for MTX discontinuation in 80% of patients who discontinued, the investigators suggested that caffeine may have interfered with MTX efficacy.
MANAGEMENT: Until further information is available, the potential for interaction should be considered in patients who consume substantial amounts of caffeine and caffeine-containing foods and are prescribed methotrexate for rheumatoid arthritis. It may be appropriate to limit caffeine intake if an interaction is suspected in cases of treatment failure.
References
- Nesher G, Mates M, Zevin S (2003) "Effect of caffeine consumption on efficacy of methotrexate in rheumatoid arthritis." Arthritis Rheum, 48, p. 571-572
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Check Interactions
To view an interaction report containing 4 (or more) medications, please sign in or create an account.
Save Interactions List
Sign in to your account to save this drug interaction list.