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PPI and methotrexate — GPhC CRA MCQ

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EasyDrug InteractionsPPI and methotrexateGPhC CRA

A patient taking high-dose methotrexate under specialist care presents a new prescription for omeprazole. The discharge letter asks the community pharmacist to check interactions. What is the most important interaction to flag?

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Correct answer: A — Omeprazole can reduce methotrexate clearance in high-dose treatment

Proton pump inhibitors can reduce clearance of methotrexate, with greatest concern in high-dose specialist regimens. The pharmacist should check the specialist plan before supply. The interaction is less straightforward in low-dose weekly use but still merits awareness.

Reference: BNF