Omeprazole inhibits the gastric hydrogen pump and is an effective trea
tment for peptic ulcers. Methotrexate is a chemotherapeutic agent that
inhibits dihydrofolate reductase and is eliminated by a hydrogen-ion-
dependent mechanism in the kidney. We present evidence that omeprazole
inhibits methotrexate clearance and may result in potentially toxic m
ethotrexate levels.