METHOTREXATE and ECSTASY

[jsixfingers]

I found a five year old thread with very minimal information about the interaction of ecstasy and methotrexate on here and it wasn't entirely helpful. So I thought perhaps anybody who is knowledgeable could comment. My lady is on 30mg of methotrexate a week for Crohns treatment. Neither of us have ever rolled but have wanted to give it a go. We have some close friends that pick it up once a month or so for personal use, we just don't know what the combo would do. If its dangerous or inadvisable, which from reading the old thread sounds like may be the case, we won't go ahead with it. But if it can be done that'd be great of course.

 

[indelibleface]

Methotrexate is a pretty heavy duty drug that puts a very big load on the liver as it is. This can have repercussions with regards to the metabolism of pretty much any other drug you put in your body - to which extent I don't know. There could be unforseen issues with ecstasy and methotrexate due to this liver load - and unfortunately I'm no doctor. Can anyone else with more medical knowledge chime in?

I would definitely wait until the treatment is over, personally. That drug has enough side effects as is.

 

[jsixfingers]

So sorry to bump this, but I was hoping somebody with some medical background would see it and respond. Don't worry, if it disappears again I won't bump it, and we won't get any E.

 

[MazDan]

Its sweet to bump it mate.

If you dont get enough response then PM a mod and we can shift it to another forum for another try.........maybe advanced drug discussion?

 

[indelibleface]

Let's just move it over to ADD so you can get a quicker response to something more technical like this.

Moving...

 

[Mariposa]

So sorry to bump this, but I was hoping somebody with some medical background would see it and respond. Don't worry, if it disappears again I won't bump it, and we won't get any E.

I'm a layperson and I have never taken methotrexate. I almost went on it this past year for psoriasis, which I later discovered was a misdiagnosis and fired my doctor. (My problem turned out to be, mostly, an allergic reaction to toxic mold.) I assume that you already know the absolute biggest no-nos which would be penicillin and pregnancy. Methotrexate has been observed to cause or worsen depression/anxiety, just working from memory with that. But the kinds of illness for which methotrexate is taken can themselves cause depression and anxiety. I did a little more homework.

See under "Alkalizing Agents" to a reference to an interaction: here.

The nature of the interaction is not specified. Likely someone else here will know. My lay opinion is that it would be very inadvisable to use the two together.

Your wife is lucky to have a husband who is as caring as you and it is good to see a new member with an excellent attitude such as yours. My best to your wife; if the Crohn's stays in remission and she is able to go off the methotrexate, wait a month and if all hepatic and renal function is preserved and your wife is overall healthy otherwise, as long as she is not on other medications that could interact with MDMA, a low dose should not cause any harm. When in doubt, though, don't.

 

[Hammilton]

I agree, the combination sounds like a really bad idea, and I'm generally one to say combinations will have no real negative effects (I mean, except for things like secobarb and ethanol).

 

[raybeez]

Methotrexate (MTX) is a inhibitor of the folic acid pathway, and works by slowing the growth of cells in the body that undergo rapid rates of growth/division. These include immune cells (making the drug immunosupressive), cells of the GI tract, mouth and skin, and malignant (cancer) cells. The direct cellular effects of MTX are unlikely to interact with MDMA in a negative way.

That being said, MTX is hepatotoxic (as mentioned by one of the posters above). Short term use of MTX doesn't cause liver damage, but hepatitis is a side effect in people taking it chronically for inflammatory disorders like rheumatoid arthritis and chron's/colitis. I can't recall the exact incidence of liver toxicity due to MTX, but aprox. 10-15% chance for life long usage is what's coming up in my head.

As mentioned above, MDMA does put a heavy load on the liver, and so taking the two drugs together could cause problems. Hepatotoxicity (i.e. liver damage) isn't absolute however, and depends on a number factors including:

1) How long the person has been on MTX. I know in rheumatological , where 10-25mg/week of MTX is used, liver function is assessed by labs and/or biopsy after a cumulative dose of 1500mg has been taken, and then again every time an additional 1000 mg has been taken. Can you estimate your wife's cumulative dose, and do you know if her liver function has ever been assessed by her doctors?

2) Whether or not your wife is taking a folate supplement. One of the mechanisms of MTX liver toxicty is depletion of hepatic folate stores. Folic acid 5mg/week or folinic acid 2.5mg/week reduces the risk of hepatoxicity. If she hasn't been on a folate supplement, I'd recommend not taking the MTX.

3) Whether or not your wife has other risk factors for liver damage including frequent use of alcohol or other hepatotoxic drugs like acetaminophen, obesity, infection with a hepatitis virus, etc.

*disclaimer*: The above post is simple medical theory and should not be taken as medical advice for your wife

 

[souRdieseL]

In no way am I saying I know much about the technical properties of it but even so I would think you shouldn't be doing any serious drugs while on methotrexate. I was on massive prednisone and methotrexate treatments along with other stuff when I was on 10 yrs old and continued for a few years. I remember every doctor I had to go to at the time every visit the biggest question was making sure my body was handling the methotrexate fine. Theres a ton of risk factors with that stuff. Btw I was on it for an eye disease called uveitis which caused lots of inflammation in my left eye causing floaters to completely block my vision.