Pharmaceutical Care Department, King Abdullah Medical City, Makkah, Saudi Arabia.
J Clin Pharm Ther. 2013 Jun;38(3):203-5. doi: 10.1111/jcpt.12060. Epub 2013 Mar 22.
Combining methotrexate (MTX) with trimethoprim-sulfamethoxazole (TS) is associated with a potential drug interaction that increases MTX toxicity. The aim of this article is to review the current literature about the potential drug interaction resulting from combining MTX with TS, and to establish therapeutic recommendations regarding their use together.
Literature for relevant evidence was searched by Medline (through PubMed), Cochrane library and a manual search through major journals for articles referenced in those located through PubMed.
One systematic review, three studies and 17 case reports were found to be relevant to the topic. Results from the current available literature clearly indicate a major drug interaction between MTX and TS, which increases the risk of MTX toxicity, like severe pancytopenia, which was fatal in some cases. Recommendations to prevent this serious interaction should be developed and implemented in the currently available therapeutic guidelines related to MTX therapy.
MTX and TS is an extremely serious and life-threatening combination that should be avoided. Practical recommendations regarding MTX use can be established to prevent harm from drug interactions. Increasing awareness of physicians, pharmacist and patients is essential to assure safe and effective MTX therapy.
甲氨蝶呤（MTX）与甲氧苄啶-磺胺甲恶唑（TS）联合使用与潜在的药物相互作用有关，这种相互作用会增加 MTX 的毒性。本文的目的是回顾目前关于 MTX 与 TS 联合使用导致潜在药物相互作用的文献，并就其联合使用建立治疗建议。
通过 Medline（通过 PubMed）、Cochrane 图书馆以及通过手动搜索主要期刊来检索与相关证据有关的文献，以查阅 PubMed 中找到的文章的参考文献。
有一项系统评价、三项研究和 17 份病例报告与该主题相关。目前现有文献的结果清楚地表明 MTX 和 TS 之间存在严重的药物相互作用，这增加了 MTX 毒性的风险，如严重的全血细胞减少症，在某些情况下是致命的。应制定并实施与 MTX 治疗相关的现有治疗指南中的建议，以预防这种严重的相互作用。
MTX 和 TS 是一种极其严重和危及生命的组合，应避免使用。可以制定关于 MTX 使用的实用建议，以防止药物相互作用造成的伤害。提高医生、药剂师和患者的认识对于确保 MTX 治疗的安全有效至关重要。
