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Clin Exp Dermatol. 1990 Sep;15(5):358-60.

Methotrexate and trimethoprim-sulphamethoxazole--a potentially hazardous combination.

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Department of Dermatology, Saint Anna Hospital, Oss, The Netherlands.


A 74-year-old woman had been treated with methotrexate over 2 years for rheumatoid arthritis. She was admitted to the hospital because of non-healing leg ulcers. After being treated with trimethoprim-sulphamethoxazole for a urinary-tract infection, she developed severe pancytopenia, followed by pneumonia and septic shock. The patient died shortly after. Concomitant treatment with methotrexate and sulphonamides should be strongly discouraged.

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[Indexed for MEDLINE]

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