Methotrexate (Oncology-Injection )/Ciprofloxacin Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Ciprofloxacin may decrease the ability of your kidneys to remove methotrexate from your body.

What might happen:

The amount of methotrexate in your body may increase, which may cause more serious, potentially life threatening side effects.

What you should do about this interaction:

Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together.Your doctor may want to monitor the amount of methotrexate in your blood, change the dose of your methotrexate, or change your antibiotic medicine. Let your doctor know right away if you develop nausea, stomach pain, yellowing of the eyes or skin, dark urine, fever, fatigue, a persistent sore throat, easy bruising or bleeding, black stools, a change in the amount of urine you pass, skin rash, breathing problems, dry cough, diarrhea, or mouth sores while taking these medicines together.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Cipro (ciprofloxacin hydrochloride) US prescribing information. Bayer Corporation May, 2020.
  • 2.Methotrexate (tablets, injection) Canada prescribing information. Pfizer Canada Inc. July 8, 2019.
  • 3.Dalle JH, Auvrignon A, Vassal G, Leverger G. Interaction between methotrexate and ciprofloxacin. J Pediatr Hematol Oncol 2002 May; 24(4):321-2.
  • 4.Jarfaut A, Santucci R, Leveque D, Herbrecht R. Severe methotrexate toxicity due to a concomitant administration of ciprofloxacin. Med Mal Infect 2013 Jan;43(1):39-41.
  • 5.Aouinti I, Gaies E, Trabelsi S, Salouage I, Jebabli N, Charfi R, Lakhal M, Klouz A. Delayed elimination of methotrexate in a patient receiving ciprofloxacin. Therapie 2013 May-Jun;68(3):175-7.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.