Methotrexate (Oncology-Injection)/Levetiracetam 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:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not process methotrexate properly.

What might happen:

Your blood levels of methotrexate may increase and cause toxic effects such as fever, chills, mouth sores, unusual bruising or bleeding, or black stools. These effects are more likely if you are taking a higher dose of methotrexate, such as doses used in the treatment of cancer.

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.If you experience swelling or soreness of the mouth or tongue, easy bruising, persistent sore mouth or fever, or unusual fatigue, contact your doctor.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.Rheumatrex (methotrexate, oral) US prescribing information. Dava Pharmaceuticals, Inc. February, 2013.
  • 2.Methotrexate sodium Inj. US prescribing information. Hospira Worldwide, Inc. March, 2018.
  • 3.Keppra (levetiracetam) US prescribing information. UCB Group of Companies November, 2016.
  • 4.Bain E, Birhiray RE, Reeves DJ. Drug-drug interaction between methotrexate and levetiracetam resulting in delayed methotrexate elimination. Ann Pharmacother 2014 Feb;48(2):292-6.
  • 5.Parentelli AS, Phulpin-Weibel A, Mansuy L, Contet A, Trechot P, Chastagner P. Drug-drug interaction between methotrexate and levetiracetam in a child treated for acute lymphoblastic leukemia. Pediatr Blood Cancer 2013 Feb; 60(2):340-1.

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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.