What the FDA labels say about taking them together
Lansoprazole and methotrexate
Lansoprazole's FDA label of June 24, 2025 names methotrexate in its drug interactions (prescription label) section; methotrexate's label does not name lansoprazole itself but warns about its class (Proton pump inhibitors (PPIs)). The lansoprazole label: “Concomitant use of PPIs with methotrexate (primarily at high dose) may elevate and prolong serum concentrations of methotrexate and/or its metabolite hydroxymethotrexate, possibly leading to methotrexate toxicities. …”
Check it at the source: the lansoprazole FDA label on DailyMed (effective June 24, 2025, L. Perrigo Company); the methotrexate FDA label on DailyMed (effective May 27, 2026, Accord Healthcare Inc.).
What does the lansoprazole label say about methotrexate?
Lansoprazole label, drug interactions (prescription label)Methotrexate Clinical Impact: Concomitant use of PPIs with methotrexate (primarily at high dose) may elevate and prolong serum concentrations of methotrexate and/or its metabolite hydroxymethotrexate, possibly leading to methotrexate toxicities. No formal drug interaction studies of high-dose methotrexate with PPIs have been conducted. Intervention: A temporary withdrawal of PREVACID or PREVACID SoluTab may be considered in some patients receiving high-dose methotrexate.
Lansoprazole label, warnings and precautions (prescription label)Increases in intragastric pH may result in hypergastrinemia and enterochromaffin-like cell hyperplasia and increased chromogranin A levels which may interfere with diagnostic investigations for neuroendocrine tumors. ( 5.9 , 7 ) Interaction with Methotrexate:
Source: FDA drug label (Prevacid 24 HR), L. Perrigo Company, effective June 24, 2025 (SPL set 205c9c1e-b422-4e86-a4b0-714b608adc19), via openFDA; the full label on DailyMed
What does the methotrexate label say about lansoprazole?
Methotrexate's label does not name lansoprazole itself; it warns about its class (Proton pump inhibitors (PPIs)):
Methotrexate label, drug interactionsOral antibiotics (including neomycin) Antifolate drugs (e.g., dapsone, pemetrexed, pyrimethamine and sulfonamides) Oral or intravenous penicillin or sulfonamide antibiotics Aspirin and other nonsteroidal anti-inflammatory drugs Highly protein-bound drugs (e.g., oral anticoagulants, phenytoin, salicylates, sulfonamides, sulfonylureas, and tetracyclines) Hepatotoxic products Proton pump inhibitors Weak acids (e.g., salicylates) Nephrotoxic products Probenecid Nitrous Oxide Coadministration of methotrexate with …
Methotrexate label, drug interactionsDRUG INTERACTIONS Aspirin, NSAIDs, and steroids: concomitant use may elevate and prolong serum methotrexate levels and cause increased toxicity ( 7.1 ) Proton pump inhibitors: concomitant use may elevate and prolong serum methotrexate levels and cause increased toxicity
Source: FDA drug label (Methotrexate), Accord Healthcare Inc., effective May 27, 2026 (SPL set 874c7f43-a3be-4236-89cc-24c44e3c5813), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Lansoprazole | Methotrexate | |
|---|---|---|
| Labeled for | Acid reflux and ulcers | Rheumatoid arthritis, Psoriasis, Leukemia, lymphoma and myeloma, Breast cancer |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.106 per capsule 30 mg capsule | $0.158 per tablet 2.5 mg tablet |
| Shortage now | No current entry | In shortage |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once