Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. Epub 2014 Sep 19. The .gov means its official. Hi thereThere is no interaction between MTX and a PPI (stomach protection) that so I would recommend you follow the advice of your Dr and take it. milligrams weekly). eHealthMe is studying from 521,855 Methotrexate users for its effectiveness, alternative drugs and more. Good luck and hope you settle down soon on whatever combination youre given. WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health. doi: 10.1097/MPH.0000000000000939. This product is available in the following dosage forms: Powder for Suspension Tablet Disintegrating, Delayed Release Capsule, Delayed of PPIs with high-dose methotrexate was a risk factor for delayed elimination For non-prescription products, read the label or package ingredients carefully. I don't know about interactions sorry. Read our, Medications to Treat Rheumatoid Arthritis, Reducing Your Risk of Adverse Medication Interactions, The Benefits of Taking Folic Acid with Methotrexate, The Tests Your IBD Doctor Should Be Ordering, Methotrexate Dosage: Uses, Reminders, Side Effects, What You Should Know About Azulfidine (Sulfasalazine) Interactions, Green Tea, Thyroid Disease, and Weight Loss, Aromatase Inhibitors to Prevent Breast Cancer Recurrence, More Arthritis Types & Related Conditions, 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for A deadly prescription: combination of methotrexate and trimethoprim-sulfamethoxazole. Our phase IV clinical studies alone cannot establish cause-effect relationship. interaction. or by reporting directly to CARM (http://carm.otago.ac.nz/). privacy practices. Methotrexate Proton Pump Inhibitors Interaction, Prescriber Update 34(3):33 I always had the enteric coated ones and actually had no problem from steroids. It is based on omeprazole and methotrexate sodium (the active ingredients of Prilosec and Methotrexate, respectively), and Prilosec and Methotrexate (the brand names). Im the same as you, I tried to avoid omperazole as I take 5mg pred as well as azathrioprine Im always feeling nauseous my stomach always sore, makes no dif to me even if I take the omperazole later in the day! Since some people may need to take a seizure medication as well as methotrexate, it may be comforting to know that some epilepsy medications dont pose a severe or moderate risk when taken with the drug. Please enable it to take advantage of the complete set of features! Dosage of drugs is not considered in the study. the levels of methotrexate in the blood and lead to adverse reactions. It may also increase the risk of cancer over long-term treatment. Versus Arthritis is registered with: Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. It is in all guidelines that PPIs should be taken with any anti inflammatory medication- I have been on MTX for 30 odd years and numbers of times during that time when Ive been on steroids or NSAIDS I have always taken a PPI to protect my stomach. WebUse the interactions A to Z to look up a drug and see which other drugs it interacts with and the severity of these interactions. Some NSAIDs can be used under direct supervision in people who take low-dose methotrexate, including: Taking methotrexate with some mental disorder medications can pose a moderate risk for adverse health effects. Careers. Co-administration of proton DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. The problem is that it omeprazole (and other PPIs, like lansoprazole) affects how quickly you body processes the methotrexate, so it can potentially increase the toxicity. No one ever reviewed or suggested I trying to come off. The manufacturers recommend that people taking phenytoin are carefully monitored if omeprazole or esomeprazole is started or stopped. * Approximation only. I take it first before my other meds. For this medicine, the following should be considered: Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. All medications have risks; paracetamol does kill people and yet most of us take it without a second though. All information is observation-only. government site. WebThe patient's serum creatinine and liver function tests were normal during treatment and follow-up. Usually avoid combinations; use it only under special circumstances. Santucci R, Leveque D, Kemmel V, et al. Some antiepileptic medications have been shown to reduce how well methotrexate works. I am sure that any rheumatologist worth their salt knows exactly what can go with what for each patient. For each condition, methotrexate works by slowing the growth of cellsincluding cancer cells in cancer and skin cells in psoriasis. PPI. )Theyve dealt with all our problems and then some over all the years and know about drug interactions. All rights reserved. I take my Omeprazole early morning,3 Sulfasalazine at 11am , Methotrexate at 2.30 ish and 2 Sulfasalazine after tea with my Etodolac. Active tubular secretion of MTX requires the activity of this pump because MTX is excreted with hydrogen ions. Why are you taking omeprazole? Adverse effects are caused by the antibiotic's ability to reduce methotrexate absorption in the body. Curr Oncol. Therefore, the elimination half-life of MTX increases, which may result in potentially toxic concentrations of MTX. DD. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. 2018 Jun 12;8(3):149-151. doi:10.1080/20009666.2018.1466598, Telles-Correia D, Barbosa A, Cortez-Pinto H, Campos C, Rocha NB, Machado S. Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity. Different individuals may respond to medication in different ways. These medications have been shown to cause adverse side effects when taken with methotrexate, including hypertension, respiratory infections, gastrointestinal distress, and headaches. All of the patients involved were MTX for osteosarcoma. Article Search Some research suggests that it can limit the efficacy of methotrexate, while others have found that adding caffeine to a treatment plan can actually reduce symptoms of methotrexate intolerance. If you have specific queries and would think you would benefit from professional advice, our Helpline is available at 0800 5200 520. Registered Charity Nos. MeSH Int J Mol Sci. Dosage of drugs is not considered in the study. Prescriber Update Omeprazole is a common drug that some people take to treat heartburn, or acid reflux. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. Adv Pharmacol Sci. This is because too much methotrexate in the body can lead to toxic effects while antiviral medications are taken at the same time. Methotrexate is known to cause severe drug interactions when taken with many types of medications. What You Need to Know About Methotrexate Interactions. Prescribers could consider temporarily withdrawing the If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Omeprazole is not recommended for people taking the antiplatelet medicine clopidogrel, because it could make clopidogrel less effective at preventing heart attacks The risk is greatest for patients taking high-dose methotrexate. Thanks so much for your reply. Those taking methotrexate should be aware of the drug interactions and speak with their healthcare provider about the drugs or supplements they are taking prior to starting treatment with methotrexate. these cases MTX elimination appeared to be delayed and the folinic acid Because NSAIDS can affect kidney function and methotrexate is metabolized by the kidney, monitoring of the creatinine is recommended. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. other information we have about you. National Institute of Diabetes and Digestive and Kidney Diseases. high-dose methotrexate. 110 significant The only medication we suspected of inhibiting MTX elimination was omeprazole 20 mg every 12 hours. After 10 years after going from Pantoprazole to ranitidine (which was suddenly withdrawn due to a cancer risk) I have finally weaned myself off and manage with just occasional Gaviscon tablets. Severe intoxication The problem is that it omeprazole (and other PPIs, like lansoprazole) affects how quickly you body processes the methotrexate, so it can potentially increase the to ensure all methotrexate and PPI data sheets contain information on this The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using these medications together can increase the blood levels and side effects of WebSevere Interactions These medications are not usually taken together. Our original studies have been referenced on 600+ medical publications including The Lancet, Mayo Clinic Proceedings, and Nature. 2017 Feb 6;8(1):26-38. doi:10.4292/wjgpt.v8.i1.26. Based on the Naranjo probability scale, a probable drug interaction was observed. Pathophysiological aspects of nephropathy caused by non-steroidal anti-inflammatory drugs. current data sheets. WebMebeverine hydrochloride and Methotrexate drug interactions - a phase IV clinical study of FDA data Summary: Drug interactions are reported among people who take Mebeverine in Sosin's paper and subsequently by Anne Stillman in the Rapid Responses. It's important to be mindful of these potential drug interactions to make sure you reap the benefit of the medication and keep side effects to a minimum. Check with your doctor or pharmacist if you have concerns or are uncertain what products may contain caffeine. 2020 Oct;47(36). I should probably just get over myself and follow the advice!Bon. Leuk Lymphoma. Speak to your healthcare provider about whether you should be taking folic acid to prevent the deficiency before supplementing on your own. ketoconazole. eHealthMe is studying from 360,002 Omeprazole users for its effectiveness, alternative drugs and more. Use of this site constitutes acceptance of eHealthMe.com's terms of service and privacy policy. It is often used in rheumatoid arthritis. Systemic lupus erythematosus (SLE)Use with caution. generic drugs) are not considered. Agarwal P, Agarwal US, Meena RS, Sharma P. A combination of oral azathioprine and methotrexate in difficult to treat dermatoses. Objective: Our original studies have been referenced on 600+ medical publications including The Lancet, Mayo Clinic Proceedings, and Nature. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. 2018 Aug;40(6):e392-e393. Devices Safety Authority, www.medsafe.govt.nz/profs/adverse/reactions.asp, Medicines Adverse Reactions Our analysis results are available to researchers, health care professionals, patients (testimonials), and software developers (open API). Methotrexate is used to treat some forms of cancer and some autoimmune I can't say Ive been specifically told about the Other drugs that have the same active ingredients (e.g. and rabeprazole) are used for the symptomatic relief of gastric reflux-like information submitted for this request. Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them. Methotrexate is known to cause severe drug interactions when taken with many types of medications. I have been on variations of Omeprazole for 25 years as Ive been on Pred for 32. I am a shocker though because I never research the meds on the web, mostly because I am not a doc. of methotrexate (odds ratio 6.66, 95% confidence interval 3.1314.17)4. J Bras Nefrol. are used together. Safety and efficacy have not been established in children younger than 1 month of age. 2014 Dec;42(12):2041-8. doi: 10.1124/dmd.114.058529. The enteric coated pred sounds like a good idea. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. All rights reserved. Is Lansoprazole better/ stronger than omeprazole? Anita Chandrasekaran, MD, MPH, is board-certified in internal medicine and rheumatology and currently works as a rheumatologist at Hartford Healthcare Medical Group in Connecticut. If we combine this information with your protected To provide you with the most relevant and helpful information, and understand which Quantifying the hepatotoxic risk of alcohol consumption in patients with rheumatoid arthritis taking methotrexate. If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date. Drug interactions are reported among people who take Prilosec and Methotrexate. Another study (74 patients and 171 cycles of methotrexate) also found 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 2014 Sep;78(3):565-71. doi: 10.1111/bcp.12384. eHealthMe is studying from 1,083 Mebeverine hydrochloride users for its effectiveness, alternative drugs and more. Anticonvulsants that are safe to take while on methotrexate include: Although many NSAIDs should not be taken with methotrexate because of the increased risk of liver toxicity, tromethamine (Tham) is one that can be safely taken with only a small risk of increasing the natural side effects of methotrexate alone. WebThere are 280 drugs known to interact with tamsulosin, along with 4 disease interactions, and 2 alcohol/food interactions. duration possible. WebMebeverine Brand names: Colofac, Colofac IBS, Aurobeverine Find out how mebeverine treats muscle spasms and stomach cramps, and how to take it. Since some people may need to take a seizure medication as well as methotrexate, it may be comforting to know that some epilepsy medications dont pose a severe or moderate risk when taken with the drug. Anticonvulsants that are safe to take while on methotrexate include: 13 26 serious drug interactions. dose 1000 times lower still seems very dubious. All rights reserved. And, of course, there's a lot of information on our website for you to search through https://www.versusarthritis.org/. odds ratio 2.65, 95% confidence interval 1.036.82) and was also a risk Would you like email updates of new search results? Competing interests: Using these medications together can increase the blood levels and side effects of methotrexate. Discussion: It is based on omeprazole and methotrexate sodium (the active ingredients of Omeprazole and Methotrexate, respectively), and Omeprazole and Methotrexate (the brand names). Stockleys Drug interactions (6ed, 2002) lists three cases where an We study millions of patients and 5,000 more each day. concludes that the interaction is not proven, as in the third case If you are a Mayo Clinic patient, this could 3,950 people who take Prilosec and Methotrexate together, and have interactions are studied. Speak to your healthcare provider about any possible immunizations you can and cannot receive. About All information is observation-only. However, elderly patients are more sensitive to the effects of this medicine than younger adults. pazopanib. So trueits all shades of grey once youre a grown up isnt it? * Approximation only. You need to ask a Pharmacist as they have a big book which lists what can and cannot be taken together, however I would have thought that if your GP prescribed them both at the same time then it should be OK. that would make sense. This medicine is available both over-the-counter (OTC) and with your doctor's prescription. eHealthMe is studying from 521,868 Methotrexate users for its effectiveness, alternative drugs and more. Methotrexate has active ingredients of methotrexate sodium. A deadly prescription: combination of methotrexate and trimethoprim-sulfamethoxazole. Some reports may have incomplete information. 2012;17(4):550-4. doi: 10.1634/theoncologist.2011-0431. The study uses data from the FDA. Yes, you can take mebeverine and omeprazole together without any serious drug interactions. If you need more assistance, please use the reply box below and let me know. It has been my pleasure to assist you and I hope I have earned a 5-star rating today. 2019 Oct;20(20):5023. doi:10.3390/ijms20205023, Patan M, Ciriaco M, Chimirri S, Ursini F, Naty S, Grembiale RD, Gallelli L, De Sarro G, Russo E. Interactions among Low Dose of Methotrexate and Drugs Used in the Treatment of Rheumatoid Arthritis. Thanks HH. All information is observation-only. Some specific NSAIDs that should be avoided while taking methotrexate include: For those with RA, which is an autoimmune disease, medication is needed to hinder the overactivity of the immune system. WebOmeprazole Interactions There are 213 drugs known to interact with omeprazole, along with 3 disease interactions. Arthritis Care Res (Hoboken). PPI. The capsule is available as a generic drug and as the brand-name drug Colazal. Ann Pharmacother. These interactions are not as dangerous as those above, but they do pose health risks. The phase IV clinical study analyzes what interactions people who take Mebeverine hydrochloride and Methotrexate have. Ann Rheum Dis. We comply with the HONcode standard for trustworthy health information. Reeves DJ, Moore ES, Bascom D, Rensing B. Br J Clin Pharmacol. WebUse WebMDs Drug Interaction Checker tool to find and identify potentially harmful and unsafe combinations of prescription medications by entering two or more drugs in question. forgive me if I've missed an introductory post from you but just wanted to welcome you to the forum. The study uses data from the FDA. It works by decreasing the amount of acid produced by the stomach. Dhir V, Sandhu A, Kaur J, Pinto B, Kumar P, Kaur P, Gupta N, Sood A, Sharma A, Sharma S. Comparison of two different folic acid doses with methotrexate--a randomized controlled trial (FOLVARI Study). Methotrexate has the potential to improve your quality of life significantly by helping you manage your condition, but it also has the potential to add to your existing health problems through drug interactions. official website and that any information you provide is encrypted It is created by eHealthMe based on reports of 19,444 people who take Omeprazole and Methotrexate from the FDA, and is updated regularly. Bon. Use of this site constitutes acceptance of eHealthMe.com's terms of service and privacy policy. The best thing to do before starting a new treatment is discuss all your medications and supplements thoroughly with your healthcare provider to avoid drug interactions. Versus Arthritis 2018. The dose of Annoyingly a dermatologist later told me that they dont prescribe high dose pred for urticaria any more . Fraenkel L, Bathon JM, England BR, et al. About mebeverine Who Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. Omeprazole is a safe drug taken by thousands of people in the UK and you'll get regular blood tests to check your kidneys and liver function so as long as you do the blood tests then you should be be fine. The patient's serum creatinine and liver function tests were normal during treatment and follow-up. Methotrexate has active ingredients of methotrexate sodium. It is often used in gastroesophageal reflux disease. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Delayed elimination of methotrexate by cola beverages in a pediatric acute lymphoblastic leukemia population. Drug interactions are reported among people who take Mebeverine hydrochloride and Methotrexate. I dont know why Im having a mental block about this when some of the other meds I take are so much more poky. Methotrexate has active ingredients of methotrexate sodium. Our analysis results are available to researchers, health care professionals, patients (testimonials), and software developers (open API). 2017 Sep;76(9):1509-1514. doi:10.1136/annrheumdis-2016-210629, Bauters T, Lammens T, Belin P, Benoit Y, Robays H, de Moerloose B. Henien M, Carey B, Hullah E, Sproat C, Patel V. I took both for a while, I needed the omeprazole because I was regularly taking naproxen to help control inflammation: both were prescribed by my rheumatologist who probably knew more about what I needed than the internet did . You can use the study as a second opinion to make health care decisions. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. Encouraging that it might not be permanent!Bon. Dosage of drugs is not considered in the study. Concomitant Administration of High-dose Methotrexate and Low-dose Aspirin Without Any Delay in Methotrexate Clearance in a Patient With Osteosarcoma: A Case Report and Review of the Literature. However, if your doctor does prescribe these medications together, you may need a dose adjustment or special tests to safely use both medications. May make these conditions worse. Prescribers are also reminded that PPIs are available over-the-counter. interaction between Methotrexate (MTX) and omeprazole was suspected, although in the third case it was later disproven. Bezabeh S, Mackey AC, Kluetz P, Jappar D, Korvick J. Oncologist. Avoid combinations; the risk of the interaction outweighs the benefit. When the absorption rate is slowed, it can lead to a buildup of the medication in the body over time and cause toxicity. Although caffeine is listed as having the ability to reduce the efficacy of methotrexate in arthritis treatment, much of the literature suggests that claim is not accurate. Bezabeh S, Mackey AC, Kluetz P, et al. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. 3. Methotrexate is the first-line treatment for most people with moderate to severerheumatoid arthritis (RA). WebClidinium helps to reduce the symptoms of stomach and intestinal cramping. All rights reserved. Federal government websites often end in .gov or .mil. Taking methotrexate and some medications will pose a moderate risk of drug interactions. Arthritis Res Ther. In one study (79 patients and 197 cycles of methotrexate), the co-administration Email this report to a friend, doctor, or patient. 19,444 people who take Omeprazole and Methotrexate together, and have interactions are studied. J Community Hosp Intern Med Perspect. 2023 eHealthMe.com. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. 3. Accumulating evidence diseases. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug interactions are reported among people who take Omeprazole and Methotrexate. information highlighted below and resubmit the form. The phase IV clinical study analyzes what interactions people who take Omeprazole and Methotrexate have. Omeprazole and Methotrexate drug interactions - from FDA reports. Summary. Drug interactions are reported among people who take Omeprazole and Methotrexate together. This study is created by eHealthMe based on reports of 13,545 people who take Omeprazole and Methotrexate from FDA, and is updated regularly. factor for renal and liver dysfunction5. The phase IV clinical study analyzes what interactions people who take Omeprazole and Methotrexate have. It is created by eHealthMe based on reports of 18,090 people who take Omeprazole and Methotrexate from the FDA, and is updated regularly. You can use the study as a second opinion to make health care decisions. To view profiles and participate in discussions please. This site complies with the HONcode standard for trustworthy health information: verify here. Drug information provided by: IBM Micromedex. 2023 eHealthMe.com. It is created by eHealthMe based on reports of 17 people who take Mebeverine hydrochloride and Methotrexate from the FDA, and is updated regularly. Omeprazole may delay MTX elimination; therefore, when prescribing MTX, an alternative to omeprazole should be considered. Probably they can be taken together. A number of drugs have been shown to impair the absorption of levothyroxine; these drugs include calcium carbonate, aluminum- containing antacids, sucralfate, iron supplements, cholestyramine, sevelamer, and, possibly, ciprofloxacin, raloxifene, and orlistat. sofosbuvir. Conclusions: I'd say probably not and in fact am the very rare case of incurring an acute kidney injury from Omeprazole. WebAll generic drug interactions for omeprazole oral (lists will include brand and generic names): 4 contraindicated drug interactions. Your body, your choice! Henien M, Carey B, Hullah E, Sproat C, Patel V. Twenty-four hours after the first high-dose MTX cycle (15 g), omeprazole was discontinued. Suzuki K, Doki K, Homma M, et al. I'll only be taking the prednisolone for label on them which says metoject has an interaction with omeprazole causing increased risk of comfortable with taking it so am after experience of anyone on here taking Omeprazole with 25mg people on MTX should not take it! Are you on 20mg omperazole, Hi Ruby. 2018 Nov 22;23(12):3062. doi: 10.3390/molecules23123062. Anyway my point is you may not be on these forever. There are of course also risks with Omeprazole itself, albeit hugely rare. Bethesda, MD 20894, Web Policies Potentially, but Ive taken omeprazole since diagnosis in 2008 & MTX the year after & my kidneys haven't reacted. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Proton Pump Inhibitors and Oncologic Treatment Efficacy: A Practical Review of the Literature for Oncologists. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. If youre already taking methotrexate, its also important to speak with your healthcare provider before taking any new natural health supplements or medications. x, Thanks so much ML. pump inhibitors. The use of the eHealthMe site and its content is at your own risk. WebOmeprazole and Methotrexate drug interactions - a phase IV clinical study of FDA data Summary: Drug interactions are reported among people who take Omeprazole and There have been several studies and case reports that have identified It is one to worry about where the effects of not taking it to protect your tummy are great and long lasting. The effects may be increased because of slower removal of the medicine from the body. With medical big data and AI algorithms, eHealthMe is running millions of phase IV trials and makes the results available to the public. Potentially, but Ive taken omeprazole since diagnosis in 2008 & MTX the year after & my kidneys haven't reacted. Drugs such as diclofenac ( Zorvolex) are more likely to affect the liver, so monitoring of the liver is recommended. adverse reactions include renal toxicity, haematologic events, mucositis Specific medications that should be avoided or used with caution include: For those taking diuretics, methotrexate may pose a moderate risk because methotrexate may hinder the actions of the diuretic medication, diminishing its therapeutic effect. PPIs should be used at the lowest dose and for shortest 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. You can discuss the study with your doctor, to ensure that all drug risks and benefits are fully discussed and understood. WebPrilosec and Methotrexate drug interactions - a phase IV clinical study of FDA data Summary: Drug interactions are reported among people who take Prilosec and Methotrexate. and myalgia. WebMethotrexate PPIs possibly reduce excretion of methotrexate, leading to an increased risk of methotrexate toxicity. Omeprazole oral capsule is used for short-term treatment of duodenal and gastric ulcers and gastroesophageal reflux disease (GERD). Accumulating evidence for a drug-drug interaction between methotrexate and proton pump inhibitors. As you have regimen containing both the drug taken along with metronidazole. If you're getting regular blood tests you should be fine, but if you have any concerns and/or feel grottier than usual you definitely need to contact you GP or Rheumatologist. And Im useless at making decisions! 2013 May;2013(1):313858. doi:10.1155/2013/313858, Lucas GNC, Leito ACC, Alencar RL, Xavier RMF, Daher EF, Silva Junior GBD.
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mebeverine and omeprazole together methotrexate