METHOTREXATE AND PROTON PUMP INHIBITORS
Two reports describe a reduction in the excretion of methotrexate in 2 patients taking omeprazole. However, similar elevations in methotrexate levels in another patient taking omeprazole were independent of omeprazole use. One patient had myalgia and elevated 7-hydroxymethotrexate levels when treated with methotrexate and pan- toprazole, and in 3 patients lansoprazole appeared to reduce methotrexate clearance and increase its levels.
The general significance of this interaction is unclear, but until more is known it would be prudent to bear this interaction in mind as a potential cause of methotrexate toxicity.
The general significance of this interaction is unclear, but until more is known it would be prudent to bear this interaction in mind as a potential cause of methotrexate toxicity.