Cyclosporine/Methotrexate 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:

Both cyclosporine and methotrexate affect your immune system. Cyclosporine may also slow down how quickly your body processes methotrexate.

What might happen:

The amount of methotrexate in your blood may increase and cause more side effects than normal. You may also have a greater risk of developing 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 and why you are taking these medicines. These medicines are not normally used together to treat psoriasis, but are used together to treat rheumatoid arthritis (RA). Your doctor may want to perform laboratory tests on you monthly to check your blood and your liver. Be sure to keep all of your laboratory appointments.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.Fox RI, Morgan SL, Smith HT, Robbins BA, Choc MG, Baggott JE. Combined oral cyclosporin and methotrexate therapy in patients with rheumatoid arthritis elevates methotrexate levels and reduces 7-hydroxymethotrexate levels when compared with methotrexate alone. Rheumatology (Oxford) 2003 Aug;42(8):989-94.
  • 2.Neoral (cyclosporine) US prescribing information. Novartis Pharmaceuticals Corporation March, 2015.
  • 3.Baraldo M, Ferraccioli G, Pea F, Gremese E, Furlanut M. Cyclosporine A pharmacokinetics in rheumatoid arthritis patients after 6 months of methotrexate therapy. Pharmacol Res 1999 Dec;40(6):483-6.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

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.