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Rheumatrex Dose Pack Oral and Zimamox

Determining the interaction of Rheumatrex Dose Pack Oral and Zimamox and the possibility of their joint administration.

Check result:

Rheumatrex Dose Pack Oral <> Zimamox

Relevance: 16.06.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Talk to your doctor before using methotrexate together with amoxicillin. Medications like amoxicillin, especially when given at high dosages for serious infections, can sometimes increase the blood levels and effects of methotrexate. You may have increased side effects such as nausea, vomiting, mouth ulcers, and low blood cell counts, which can make you more likely to develop anemia, bleeding problems, and infections. Contact your doctor if you experience potential signs and symptoms of these conditions such as paleness, fatigue, dizziness, fainting, unusual bleeding or bruising, fever, chills, sore throat, body aches, or other flu-like symptoms. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR CLOSELY: Concomitant use of large doses of penicillins may elevate serum methotrexate concentrations. The mechanism may involve competitive inhibition of renal tubular secretion of methotrexate. In one study, methotrexate clearance reductions were 35%, 40%, and 66% with penicillin, ticarcillin, and piperacillin, respectively. Serious adverse effects, primarily hematologic, have been described with concurrent penicillins and high or low-dose methotrexate regimens. Fatalities have occurred with both types of methotrexate regimens.

MANAGEMENT: If a penicillin must be used concurrently, close monitoring of methotrexate serum concentrations and of the patient for evidence of serious methotrexate toxicity are recommended. Leucovorin rescue should be available. Methotrexate dose reductions may be necessary. If broad-spectrum antibiotic coverage is needed during high-dose methotrexate therapy, use of other antimicrobials may be preferable. Patients should be advised to promptly report symptoms including fever, chills, sore throat, bruising, bleeding, stomatitis, or malaise to their physician.

References

"Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
Titier K, Lagrange F, Pehourcq F, Moore N, Molimard M "Pharmacokinetic interaction between high-dose methotrexate and oxacillin." Ther Drug Monit 24 (2002): 570-2
"Product Information. Methotrexate and Methotrexate LPF (methotrexate)." Lederle Laboratories, Wayne, NJ.
Yamamoto K, Sawada Y, Matsushita Y, Moriwaki K, Bessho F, Iga T "Delayed elimination of methotrexate associated with piperacillin administration." Ann Pharmacother 31 (1997): 1261-2
Dean R, Nachman J, Lorenzana AN "Possible methotrexate-mezlocillin interaction." Am J Pediatr Hematol Oncol 14 (1992): 88-92
Nierenberg DW, Mamelok RD "Toxic reaction to methotrexate in a patient receiving penicillin and furosemide: a possible interaction." Arch Dermatol 119 (1983): 449-50
"Product Information. Zosyn (piperacillin-tazobactam)." Lederle Laboratories, Wayne, NJ.
Bloom EJ, Ignoffo RJ, Reis CA, Cadman E "Delayed clearance (CL) of methotrexate (MTX) associated with antibiotics and antiinflammatory agents." Clin Res 34 (1986): a560
Ronchera CL, Hernandez T, Peris JE, Torres F, et al. "Pharmacokinetic interaction between high-dose methotrexate and amoxycillin." Ther Drug Monit 15 (1993): 375-9
Mayall B, Poggi G, Parkin JD "Neutropenia due to low-dose methotrexate therapy for psoriasis and rheumatoid arthritis may be fatal." Med J Aust 155 (1991): 480-4

Rheumatrex Dose Pack Oral

Generic Name: methotrexate

Brand name: Rheumatrex Dose Pack, Trexall, Xatmep, Otrexup, Rasuvo, Methotrexate Sodium, Preservative Free

Synonyms: Rheumatrex Dose Pack, Rheumatrex

What is Rheumatrex Dose Pack Oral?

Zimamox

Generic Name: amoxicillin

Brand name: Amoxil, Moxatag, Trimox

Synonyms: Amoxicillin

What is Zimamox?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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