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Does Nonsteroidal Anti Inflammatory Drugs Nsaids Interact with Methotrexate?

Nonsteroidal Anti Inflammatory Drugs Nsaids and Methotrexate have a contraindicated drug interaction according to U.S. FDA drug labeling data. NSAIDs should not be administered prior to or concomitantly with high-dose methotrexate. Concomitant administration has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and gastrointestinal toxicity. The mechanism involves reduce tubular secretion of methotrexate. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.

Severity
Contraindicated
Methotrexate Class
Folate Analog Metabolic Inhibitor
Management
Do not take together
Data Source
U.S. FDA via OpenFDA

How This Interaction Works

The interaction between Nonsteroidal Anti Inflammatory Drugs Nsaids and Methotrexate occurs because reduce tubular secretion of methotrexate. Clinically, this means nsaids should not be administered prior to or concomitantly with high-dose methotrexate. concomitant administration has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and gastrointestinal toxicity. Because of the severity of this interaction, these medications are contraindicated — meaning they should not be taken together under any circumstances. If you are currently taking both, contact your healthcare provider immediately to discuss alternatives.

What To Tell Your Doctor or Pharmacist

If you are taking Nonsteroidal Anti Inflammatory Drugs Nsaids and your doctor is considering prescribing Methotrexate (or vice versa), make sure to:

  • Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
  • Ask whether the benefits of combining these medications outweigh the risks for your specific situation
  • Ask what symptoms to watch for that would indicate the interaction is causing problems
  • Ask about alternative medications that do not interact with your current regimen
  • Ask how frequently you should be monitored while these are co-prescribed
  • Never stop or change either medication without first consulting your healthcare provider
💊 Nonsteroidal Anti Inflammatory Drugs Nsaids+💊 Methotrexate(Methotrexate)

Severity & Interaction Details

⛔
contraindicated
Avoid this combination
FDA labeling lists this pair as contraindicated. The risk outweighs the benefit in nearly all cases.
Severity scale
MinorContra
On record
Yes
Drug A class
—
Drug B class
Folate Analog Metabolic Inhibitor
Source
NLP:methotrexate

What this means in plain English

NSAIDs should not be administered prior to or concomitantly with high-dose methotrexate. Concomitant administration has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and gastrointestinal toxicity.

What the FDA label says

"Reduce tubular secretion of methotrexate"

📖 Source: NLP:methotrexate

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Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine. For informational purposes only. Always consult your pharmacist or physician.