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Does Natalizumab Interact with Methotrexate?

Natalizumab and Methotrexate have a contraindicated drug interaction according to U.S. FDA drug labeling data. Should not be used concomitantly with natalizumab due to potential increased risk of PML and other infections. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.

Severity
Contraindicated
Natalizumab Class
Integrin Receptor Antagonist
Methotrexate Class
Folate Analog Metabolic Inhibitor
Management
Do not take together
Data Source
U.S. FDA via OpenFDA

What To Tell Your Doctor or Pharmacist

If you are taking Natalizumab and your doctor is considering prescribing Methotrexate (or vice versa), make sure to:

  • Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
  • Ask whether the benefits of combining these medications outweigh the risks for your specific situation
  • Ask what symptoms to watch for that would indicate the interaction is causing problems
  • Ask about alternative medications that do not interact with your current regimen
  • Ask how frequently you should be monitored while these are co-prescribed
  • Never stop or change either medication without first consulting your healthcare provider
💊 Natalizumab(Tyruko)+💊 Methotrexate(Otrexup)

Severity & Interaction Details

⛔
contraindicated
Avoid this combination
FDA labeling lists this pair as contraindicated. The risk outweighs the benefit in nearly all cases.
Severity scale
MinorContra
On record
Yes
Drug A class
Integrin Receptor Antagonist
Drug B class
Folate Analog Metabolic Inhibitor
Source
NLP:natalizumab

What this means in plain English

Should not be used concomitantly with natalizumab due to potential increased risk of PML and other infections.

About Natalizumab and Methotrexate

Natalizumab is an Integrin Receptor Antagonist, while Methotrexate is a Folate Analog Metabolic Inhibitor. You may recognize them by the brand names Tyruko and Otrexup. Natalizumab is given by intravenous (IV) infusion, whereas Methotrexate is given by intramuscular injection. Both Natalizumab and Methotrexate carry an FDA boxed warning — the agency's most serious safety designation.

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Data integrity: Every interaction shown is extracted directly from official U.S. FDA drug labeling via openFDA and the U.S. National Library of Medicine (NIH) — no interactions are invented, inferred, or manually edited. Maintained by CheckDrugInteractions.com. See our methodology or report a correction at support@checkdruginteractions.com.

Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine, supplemented with a small number of well-established interactions from curated clinical references. For informational purposes only. Always consult your pharmacist or physician.