side effects
2 interactions related to side effects
methotrexate + folate
Methotrexate works by blocking the enzyme that recycles folate into its active form, which depletes folate in normal tissues and drives common side effects such as nausea, mouth sores, and elevated liver enzymes. Folic acid supplementation reduces these side effects without compromising efficacy at the doses used for autoimmune disease, but it should not be taken on the same day as methotrexate, and it should never be added on your own when methotrexate is used for cancer.
smoking + varenicline
Varenicline (Chantix/Champix) is a partial agonist at the alpha4-beta2 nicotinic acetylcholine receptor — the same receptor nicotine targets. It makes smoking less rewarding, so it is started before your quit date and you may keep smoking briefly at first. Combining varenicline with nicotine replacement (patches, gum) can raise quit rates but increases side effects such as nausea, headache, vomiting, and dizziness.