Esmosec 40 IV Esomeprazole Methotrexate
MajorPPIs may delay methotrexate elimination, raising levels and toxicity, mainly with high-dose methotrexate.
These medicines can affect each other in a serious way. Do not start taking them together unless your doctor has said it is OK. If you already take both, do not stop either one on your own: speak to your doctor or pharmacist soon.
Clinical management: Consider temporarily withdrawing PPI during high-dose methotrexate; monitor levels.