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Methotrexate and fluconazole

Authoring team

Liver toxicity

  • concomitant use of methotrexate and fluconazole can increase the risk of liver toxicity

Suggested management options (1)

  • routine monitoring of methotrexate should detect any signs of liver toxicity
  • In the presence of a severe acute or chronic infection, some people on stable methotrexate therapy can miss doses of methotrexate whilst taking the course of fluconazole
    • restart methotrexate once they feel better.

Reference:

  1. NHS Specialist Pharmacy Service (June 30th 2025). Managing interactions with methotrexate

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