Methotrexate and Ketamine Therapy | Tovani Health
Trexall (Methotrexate) (also: Otrexup, Rasuvo) — Antimetabolite / DMARD (autoimmune, cancer)
Verdict at Tovani Health
Fully compatible with KAP.
Methotrexate and ketamine have no clinically significant interaction. The standard methotrexate precautions (renal function, hepatotoxicity, marrow suppression monitoring, folic acid supplementation) are unchanged by KAP.
If you take Trexall regularly and are considering at-home ketamine therapy, the combination is generally safe at therapeutic doses. This page covers the brief pharmacologic context and what we do at intake.
How Trexall interacts with ketamine
Methotrexate inhibits dihydrofolate reductase. Used in low weekly doses for rheumatoid arthritis, psoriasis, and other autoimmune conditions, and in high doses for cancer chemotherapy. No CYP interactions of clinical significance with ketamine.
What we do at intake
Continue as prescribed. Maintain your usual lab monitoring schedule. Disclose folic acid supplementation.
Bottom line
Methotrexate and ketamine have no clinically significant interaction. The standard methotrexate precautions (renal function, hepatotoxicity, marrow suppression monitoring, folic acid supplementation) are unchanged by KAP.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Trexall (Methotrexate) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 17, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.