Avoid combining prednisone or methotrexate with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen. This combination increases your risk of stomach ulcers and bleeding.
Prednisone Interactions:
- Live vaccines: Postpone vaccinations until your prednisone course ends, as it can weaken your immune response. Potassium-depleting diuretics: These medications, like furosemide (Lasix), can exacerbate potassium loss, already a side effect of prednisone. Your doctor may monitor your potassium levels. Digoxin: Prednisone may increase the effects of digoxin (a heart medication), potentially leading to toxicity. Regular blood tests are often recommended. Warfarin: Prednisone can impact the blood-thinning effects of warfarin, requiring close monitoring of your INR (international normalized ratio). Oral contraceptives: Prednisone can reduce the effectiveness of birth control pills. Discuss alternative contraception methods with your doctor.
Methotrexate Interactions:
Alcohol: Avoid alcohol consumption as it can worsen liver damage, a potential side effect of methotrexate. Aspirin and other NSAIDs: Similar to prednisone, combining methotrexate with these increases the risk of gastrointestinal issues. Folic acid supplements (high doses): While low-dose folic acid supplementation is sometimes recommended, high doses can interfere with methotrexate’s effectiveness. Always follow your doctor’s instructions. Sulfonamides: These antibiotics can increase the toxicity of methotrexate. Discuss other antibiotic options with your physician. Salicylates (except low-dose aspirin): These medications can increase the risk of methotrexate toxicity.
This is not an exhaustive list. Always inform your doctor and pharmacist of all medications, supplements, and herbal remedies you are taking, before starting either prednisone or methotrexate. They can help identify potential interactions and adjust your treatment plan accordingly. Regular monitoring of your health is crucial while on these medications.
