Drug General Information (ID: DDIWG8TC29)
Drug Name			Methotrexate		Drug Info		Neomycin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antimetabolites				Antibiotics
Structure

Mechanism of Methotrexate-Neomycin Interaction (Severity Level: Moderate)
Altered absorption (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Methotrexate				Neomycin
Mechanism		Absorption affected by oral aminoglycosides-induced malabsorption				Malabsorption
Key Mechanism Factor 1
		Factor Name		Pharmacokinetic
		Factor Description		Alters the absorption of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
Mechanism Description		Altered absorption of Methotrexate caused by Neomycin

Recommended Action
Management		Patients should be closely monitored for altered efficacy and safety of methotrexate. Consider the intravenous route of administration for methotrexate to avoid the interaction.

References
1	Keusch GT, Troncale FJ, Buchanan RD "Malabsorption due to paromomycin." Arch Intern Med 125 (1970): 273-6. [PMID: 5412015]
2	Shen DD, Azarnoff DL "Clinical pharmacokinetics of methotrexate." Clin Pharmacokinet 3 (1978): 1-13. [PMID: 346283]
3	Cohen MH, Creaven PJ, Fossieck BE, Johnston AV, Williams CL "Effect of oral prophylactic broad spectrum nonabsorbable antibiotics on the gastrointestinal absorption of nutrients and methotrexate in small cell bronchogenic carcinoma patients." Cancer 38 (1976): 1556-9. [PMID: 186170]