Miconazole and Trimetrexate: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Miconazole
Trimetrexate
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased trimetrexate toxicity (bone marrow suppression, renal & hepatic dysfunction, and gastrointestinal ulceration)
Interaction Deep Dive
Drugs such as miconazole that inhibit the P450 enzyme system may cause drug interactions that increase trimetrexate plasma concentrations1.
Why it happens (mechanism)
Decreased trimetrexate metabolism
Common questions
Can I take Miconazole and Trimetrexate together?
Increased trimetrexate toxicity (bone marrow suppression, renal & hepatic dysfunction, and gastrointestinal ulceration) Always confirm with your pharmacist or prescriber before making any change.
How serious is the Miconazole and Trimetrexate interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Miconazole or Trimetrexate need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: Neutrexin(R), trimetrexate. US Bioscience, West Conshohocken, PA, 1993.
Keep reading about Miconazole
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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