Drug & supplement interaction

Balneotherapy + Methotrexate

Methotrexate brand names: Rheumatrex, Otrexup, Rasuvo, Reditrex.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Balneotherapy and Methotrexate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Balneotherapy and Methotrexate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Methotrexate and Balneotherapy in our sources. This does not guarantee that the combination is completely free of risk — research on Balneotherapy alongside specific medications may be limited.

Worth understanding: our licensed dataset holds no drug-interaction record for Balneotherapy at all — not against Methotrexate, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

Balneotherapy is a treatment rather than something you take. Tell whoever provides it which medicines you use, and ask your prescriber whether it is appropriate for your health and treatment. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Balneotherapy safety at a glance

Balneotherapy overall Use caution Generally low-risk for healthy adults, but warm or hot water bathing isn't safe for everyone.
Pregnancy Possibly Unsafe When heated balneotherapy is used. Conditions that increase maternal core temperature above 39°C have been associated with increased risk of teratogenicity. Som... Read the full pregnancy detail
Breastfeeding Use caution Likely low-risk for ordinary warm baths, but limited data exist on therapeutic spa treatments.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Methotrexate and Balneotherapy? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Balneotherapy and Methotrexate May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so having Balneotherapy while taking the medicine can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • A higher chance of infection Worth acting on Additional detail

    Balneotherapy

    “Balneotherapy is well tolerated when used appropriately, short term. Adverse effects attributed to balneotherapy have rarely been reported in clinical trials. They may include changes in blood pressure, cardiac arrhythmia, mild redness and burning of the skin, increased risk of infections, weakness, and insomnia.”

    Balneotherapy · Natural Medicines adverse-effect record, reported in arrhythmia.

    6 sources cited
    1. 98387. Karagülle M, Kardes S, Disçi R, Karagülle MZ. Spa therapy adjunct to pharmacotherapy is beneficial in rheumatoid arthritis: a crossover randomized controlled trial. Int J Biometeorol. 2018;62(2):195-205. PubMed
    2. 98390. Kovács C, Bozsik Á, Pecze M, et al. Effects of sulfur bath on hip osteoarthritis: a randomized, controlled, single-blind, follow-up trial: a pilot study. Int J Biometeorol. 2016;60(11):1675-1680. PubMed
    3. 98393. Naumann J, Sadaghiani C. Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials. Arthritis Res Ther. 2014;16(4):R141. PubMed
    4. 103537. Gáti T, Tefner IK, Kovács L, Hodosi K, Bender T. The effects of the calcium-magnesium-bicarbonate content in thermal mineral water on chronic low back pain: a randomized, controlled follow-up study. Int J Biometeorol. 2018;62(5):897-905. PubMed
    5. 103540. Farina S, Gisondi P, Zanoni M, et al. Balneotherapy for atopic dermatitis in children at Comano spa in Trentino, Italy. J Dermatolog Treat. 2011;22(6):366-71. PubMed
    6. 103541. Dubois O, Salamon R, Germain C, et al. Balneotherapy versus paroxetine in the treatment of generalized anxiety disorder. Complement Ther Med. 2010;18(1):1-7. PubMed

    “Respiratory tract, skin, and urinary tract infections possibly related to balneotherapy have been reported.”

    Balneotherapy · Natural Medicines adverse-effect record, reported in urinary tract infections (utis).

    2 sources cited
    1. 103537. Gáti T, Tefner IK, Kovács L, Hodosi K, Bender T. The effects of the calcium-magnesium-bicarbonate content in thermal mineral water on chronic low back pain: a randomized, controlled follow-up study. Int J Biometeorol. 2018;62(5):897-905. PubMed
    2. 103541. Dubois O, Salamon R, Germain C, et al. Balneotherapy versus paroxetine in the treatment of generalized anxiety disorder. Complement Ther Med. 2010;18(1):1-7. PubMed

    Methotrexate

    Listed in the ADVERSE REACTIONS section of the FDA label for Methotrexate. Read the label on DailyMed ›

  • Low blood pressure Additional detail

    Balneotherapy

    “Hypotension, hypertension, and cardiac arrhythmia possibly related to balneotherapy have been rarely reported.”

    Balneotherapy · Natural Medicines adverse-effect record, reported in arrhythmia.

    2 sources cited
    1. 103537. Gáti T, Tefner IK, Kovács L, Hodosi K, Bender T. The effects of the calcium-magnesium-bicarbonate content in thermal mineral water on chronic low back pain: a randomized, controlled follow-up study. Int J Biometeorol. 2018;62(5):897-905. PubMed
    2. 103541. Dubois O, Salamon R, Germain C, et al. Balneotherapy versus paroxetine in the treatment of generalized anxiety disorder. Complement Ther Med. 2010;18(1):1-7. PubMed

    Methotrexate

    Listed in the ADVERSE REACTIONS section of the FDA label for Methotrexate. Read the label on DailyMed ›

Reported for Balneotherapy but not commonly for Methotrexate: an irregular heartbeat, raised blood pressure and trouble sleeping.

Effects for Methotrexate come from the ADVERSE REACTIONS section of its FDA label; effects for Balneotherapy come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 489,806 voluntary FDA FAERS reports for Methotrexate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Balneotherapy in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When heated balneotherapy is used. Conditions that increase maternal core temperature above 39°C have been associated with increased risk of teratogenicity. Some early research also found an association between maternal heat exposure in the form of a hot tub or sauna during the first trimester and increased risk of neural tube defects. While a more recent analysis of clinical research shows that it is safe for pregnant women to sit in hot baths at 40°C (104°F) or in saunas at 70°C (158°F) for up to 20 minutes, regardless of trimester, clinical practice guidelines by the American College of Obstetricians and Gynecologists still discourage pregnant women from using hot water baths during pregnancy due to possible risks. Until more is known, pregnant women should avoid hot balneotherapy baths and other treatments. There is insufficient reliable information available about the safety of balneotherapy heated to less than 39°C; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Overlapping uses

What Methotrexate Is Prescribed For, and What Balneotherapy Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Methotrexate is a prescription medicine with approved uses on its FDA label. Balneotherapy is a treatment: what follows is what researchers have looked at it for, and how strong that evidence is.

Methotrexate is prescribed for: Methotrexate treats a wide range of serious conditions. In cancer care, it is used for acute lymphoblastic leukemia, non-Hodgkin lymphoma, osteosarcoma, breast cancer, head and neck cancer, and gestational trophoblastic neoplasia (a rare tumor related to pregnancy). It is also used to prevent and treat meningeal leukemia (cancer affecting the lining of the brain and spinal cord). Outside of cancer, methotrexate is prescribed for adults with rheumatoid arthritis (RA), children with polyarticular juvenile idiopathic arthritis (a form of childhood arthritis), and adults with severe psoriasis that hasn't responded well to other treatments.

Balneotherapy has been studied for:

  • Psoriasis studied, not established Balneotherapy has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Balneotherapy for psoriasis

    Preliminary clinical research shows that Leopoldine spa water, which is hypotonic water rich in sulfate, reduces the area of the skin affected by psoriasis when compared with distilled water. Preliminary clinical research in adults with chronic plaque psoriasis shows that a standardized 3-week course of spa therapy, including balneotherapy, improves the Dermatology Life Quality Index (DLQI) to a score of less than 10…

    2 sources cited
    1. 16195. Tsoureli-Nikita E, Menchini G, Ghersetich I, Hercogova J. Alternative treatment of psoriasis with balneotherapy using Leopoldine spa water. J Eur Acad Dermatol Venereol 2002;16:260-2. PubMed
    2. 111200. Beylot-Barry M, Mahé E, Rolland C, et al. Evaluation of the benefit of thermal spa therapy in plaque psoriasis: the PSOTHERMES randomized clinical trial. Int J Biometeorol. 2022 Jun;66(6):1247-56. PubMed

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Methotrexate on your own; if you are taking Balneotherapy for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Balneotherapy or Methotrexate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Balneotherapy or Methotrexate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Methotrexate

This page covers Balneotherapy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methotrexate page lists 82 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Beer (major), Grapefruit (major) and Siberian Cocklebur (major).

By severity: 7 major · 60 moderate · 15 minor.

From our pharmacist’s overview on the Methotrexate page

“The liver is where methotrexate and supplements clash most. Methotrexate (Rheumatrex, Otrexup, Rasuvo), used for rheumatoid arthritis, psoriasis, and certain cancers, can strain the liver on its own, and 38 of the 82 interacting ingredients on this list add liver risk of their own, alcohol included, which makes this a list to approach…”

Reviewed by 2 · Jul 18, 2026

Open the Methotrexate interaction page

How much people look this up

Where Balneotherapy and Methotrexate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Balneotherapy
Top half

#620 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Methotrexate
Top 5%

#49 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Balneotherapy reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Balneotherapy and Methotrexate records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Treatment approach

About Balneotherapy

What is Balneotherapy?

  • Osteoarthritis joint pain
  • Rheumatoid arthritis
  • Low back pain
  • Fibromyalgia
  • Psoriasis and skin conditions
  • Relaxation and stress relief

Balneotherapy is a traditional treatment that uses bathing in mineral-rich or thermal water, often combined with mud or other natural elements, mainly for joint and skin problems. Some studies suggest it may ease pain and stiffness in conditions like osteoarthritis, but the quality of evidence is limited and benefits may be short-term. It is generally considered low-risk for healthy adults, but people with heart problems, open wounds, or certain medical conditions should check with a doctor first.

Mineral water, thermal spring water, mud, and other natural bathing media · Mineral or thermal baths, mud packs, spa hydrotherapy, sulfur baths, Dead Sea bathing

An interaction check asks whether these two react with each other — it does not ask whether Balneotherapy is a good idea for someone in your situation. Here is what our Balneotherapy record says about it on its own.

Balneotherapy: dosing

There is no single standardized "dose" for balneotherapy. Treatment programs vary widely in water temperature, mineral content, length of each session, and number of sessions per week. Avoid very hot water and overly long sessions, and stop if you feel dizzy, overheated, or unwell.

From our Balneotherapy monograph — the full record covers uses, side effects and every documented interaction.

Read the full Balneotherapy monograph & all interactions
Medication

About Methotrexate

What Is Methotrexate Used For?

Brand names: Rheumatrex, Otrexup, Rasuvo, Reditrex

Methotrexate treats a wide range of serious conditions. In cancer care, it is used for acute lymphoblastic leukemia, non-Hodgkin lymphoma, osteosarcoma, breast cancer, head and neck cancer, and gestational trophoblastic neoplasia (a rare tumor related to pregnancy). It is also used to prevent and treat meningeal leukemia (cancer affecting the lining of the brain and spinal cord).

Outside of cancer, methotrexate is prescribed for adults with rheumatoid arthritis (RA), children with polyarticular juvenile idiopathic arthritis (a form of childhood arthritis), and adults with severe psoriasis that hasn't responded well to other treatments.

Most-Reported Side Effects for Methotrexate

From FAERS, the FDA’s public side-effect reporting system (489,806 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Rheumatoid arthritis 42,798 reports
Arthralgia 40,830 reports
Fatigue 33,049 reports
Nausea 28,999 reports
Joint swelling 25,026 reports
See full Methotrexate drug information
Keep checking

Other Drugs & Balneotherapy

Browse every other medication we’ve checked against Balneotherapy — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Balneotherapy against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Balneotherapy list.

See the full Balneotherapy interactions page
See every supplement checked against Methotrexate, ranked by severity
Evidence & sources

Balneotherapy References

The 31 references that drive our Balneotherapy monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Sukenik S, Baradin R, Codish S, et al. Balneotherapy at the Dead Sea area for patients with psoriatic arthritis and concomitant fibromyalgia. Isr Med Assoc J 2001;3:147-50.
  2. Ardic F, Ozgen M, Aybek H, et al. Effects of balneotherapy on serum IL-1, PGE2 and LTB4 levels in fibromyalgia patients. Rheumatol Int 2007;27:441-6. PubMed
  3. Altan L, Bingol U, Aslan M, Yurtkuran M. The effect of balneotherapy on patients with ankylosing spondylitis. Scand J Rheumatol 2006;35:283-9. PubMed
  4. Pittler MH, Karagulle MZ, Karagulle M, Ernst E. Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials. Rheumatology (Oxford) 2006;45:880-4. PubMed
  5. Yurtkuran M, Ay A, Karakoc Y. Improvement of the clinical outcome in Ankylosing spondylitis by balneotherapy. Joint Bone Spine 2005;72:303-8. PubMed
  6. Tsoureli-Nikita E, Menchini G, Ghersetich I, Hercogova J. Alternative treatment of psoriasis with balneotherapy using Leopoldine spa water. J Eur Acad Dermatol Venereol 2002;16:260-2. PubMed
  7. Evicik D, Kizilay B, Gokcen E. The effects of balneotherapy on fibromyalgia patients. Rheumatol Int 2002;22:56-9. PubMed
  8. Buskila D, Abu-Shakra M, Neumann L, et al. Balneotherapy for fibromyalgia at the Dead Sea. Rheumatol Int 2001;20:105-8. PubMed
  9. Ravanelli N, Casasola W, English T, Edwards KM, Jay O. Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis. Br J Sports Med. 2018;0:1-8. PubMed
  10. Milunsky A, Ulcickas M, Rothman KJ, et al. Maternal heat exposure and neural tube defects. JAMA. 1992;268(7):882-5. DOI
  11. [No authors listed]. ACOG Committee Opinion No. 650: physical activity and exercise during pregnancy and the postpartum period. Obstet Gynecol 2015;126:e135-42. PubMed
  12. Bagdatli AO, Donmez A, Eröksüz R, Bahadir G, Turan M, Erdogan N. Does addition of 'mud-pack and hot pool treatment' to patient education make a difference in fibromyalgia patients? A randomized controlled single blind study. Int J Biometeorol. 2015;59(12) PubMed
  13. Karagülle M, Kardes S, Disçi R, Karagülle MZ. Spa therapy adjunct to pharmacotherapy is beneficial in rheumatoid arthritis: a crossover randomized controlled trial. Int J Biometeorol. 2018;62(2):195-205. PubMed
  14. Karagülle M, Kardes S, Karagülle MZ. Long-term efficacy of spa therapy in patients with rheumatoid arthritis. Rheumatol Int. 2018;38(3):353-362. PubMed
  15. Koçyigit BF, Gür A, Altindag Ö, Akyol A, Gürsoy S. Comparison of education and balneotherapy efficacy in patients with fibromyalgia syndrome: A randomized, controlled clinical study. Agri. 2016;28(2):72-8. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Having Balneotherapy While Taking Methotrexate: Common Questions

Is it safe to have Balneotherapy while taking Methotrexate?
We do not list a known interaction between Balneotherapy and Methotrexate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Balneotherapy and Methotrexate have any of the same side effects?
Yes — our sources link each of them separately to 2 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Balneotherapy and Methotrexate used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Balneotherapy in each. That is a conversation for your prescriber, especially if Methotrexate is being adjusted to a target.
Does Methotrexate interact with any supplements?
Yes. Methotrexate has documented interactions with 82 supplements in our database — Balneotherapy is not one of them. The Methotrexate interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Balneotherapy monograph Uses, safety profile, and every drug interaction in one place Methotrexate drug information The full plain-English guide to this medication Methotrexate supplement interactions Every supplement checked against Methotrexate, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 31 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Methotrexate and Balneotherapy?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.