Can I take Methotrexate and Tylenol together?

Why this happens

Both drugs are processed by the liver, and paracetamol may slightly interfere with how the kidneys remove methotrexate from the body. If methotrexate levels rise too high, it can lead to side effects. Additionally, both drugs can affect liver function, so taking them together requires monitoring.

What you should do

You can usually take paracetamol with methotrexate, but you must stay within the recommended daily dose of paracetamol (no more than 4,000mg or eight 500mg tablets in 24 hours). Always inform your doctor if you are taking paracetamol regularly, as they may want to monitor your liver function tests more closely. If you notice yellowing of the skin or eyes (jaundice), dark urine, or severe stomach pain, contact your doctor immediately.

Important precautions

Pregnancy and Fathering a Child

Methotrexate causes severe birth defects and miscarriage. You must use effective contraception during treatment and for at least 6 months after stopping. This applies to both men and women.

Infection and Blood Disorders

Methotrexate can suppress your immune system and bone marrow. You must seek immediate medical help if you develop a fever, sore throat, mouth ulcers, or unexplained bruising/bleeding.

Liver Function and Alcohol Consumption

Both medicines are processed by the liver. You must strictly limit or avoid alcohol, as the combination significantly increases the risk of severe liver damage.

Food and drink warnings

Alcohol

You should strictly limit or avoid alcohol while taking methotrexate. Both alcohol and methotrexate can cause liver damage; using them together significantly increases the risk of serious liver toxicity (hepatotoxicity).

Caffeine (Coffee, Tea, Cola)

High intake of caffeine may reduce the effectiveness of methotrexate for some conditions, such as rheumatoid arthritis. If you notice your symptoms worsening, you may need to limit your caffeine intake.

Dairy products

Milk and dairy products contain an enzyme called xanthine oxidase which can break down methotrexate in the digestive tract. To ensure you get the full dose, avoid consuming large amounts of dairy at the same time you take your methotrexate tablets.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.