Does anyone take pantoprazole with MtX?

[krillemy]

During this weekend I have had a bad pain in my esophagus. I get that from time to time, probably due reflux caused by the prednisolone and PMR, as it is worse during a flare.

I usually take pantoprazole a couple of days and it heals up fast (doctor's prescription).

However - now I am on MtX since mid August. No side effect yet! But can I take pantoprazole with the MtX. The inserts and guidelines says "talk to your doctor", but with no effect from many Alminox and no effect with painkillers, I took the chance last night and had 40 mg pantoprazole!

I am still here 😅 pain free😊

What advice have you been given by doctors?

[PMRpro Ambassador]

The interaction is that the PPI can increase the levels of MTX in the blood and so increase the adverse effects and toxicity - but it relates to high dose MTX as used in oncology for malignancies rather than the low doses used in rheumatology. There is apparently no problem with H2-antagonists such as famotidine or cimetidine.

ncbi.nlm.nih.gov/pmc/articl...

[krillemy in reply to PMRpro]

So only relevant in high MtX dosages is my take Thanks

[PMRpro Ambassador in reply to krillemy]

As a serious problem, yes.