Details of Drug-Drug Interaction
| Drug General Information (ID: DDIYWLDUX2) | |||||||||
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| Drug Name | Methotrexate | Drug Info | Dexlansoprazole | Drug Info | |||||
| Drug Type | Small molecule | Small molecule | |||||||
| Therapeutic Class | Antimetabolites | Proton Pump Inhibitors | |||||||
| Structure | |||||||||
| Mechanism of Methotrexate-Dexlansoprazole Interaction (Severity Level: Major) | |||||||||
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| Competitive inhibition of renal tubular secretion Click to Show/Hide Mechanism Graph | |||||||||
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| Drug Name | Methotrexate | Dexlansoprazole | |||||||
| Mechanism | Methotrexate | Inhibition of the renal tubular secretion of methotrexate | |||||||
| Key Mechanism Factor 1 | |||||||||
| Factor Name | Renal tubular secretion | ||||||||
| Factor Description | Renal tubular secretion allows selective transfer of substances from the blood around the capillaries into the renal tubules via filtrate. Drug excretion may be reduced when two drugs compete for renal tubular secretion. | ||||||||
| Mechanism Description |
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| Recommended Action | |||||||||
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| Management | Proton pump inhibitor therapy should preferably be stopped several days prior to administration of methotrexate. In addition, it is not generally recommended to use proton pump inhibitors with high-dose methotrexate therapy, particularly in the presence of renal impairment. If concomitant use is necessary, clinicians should consider the potential for interaction and closely monitor methotrexate serum levels and toxicity. Use of an H2 antagonist may also be an appropriate alternative. It is not known if the interaction occurs with low, oral doses of methotrexate used to treat rheumatoid arthritis. | ||||||||