Are you comfortable with using NSAIDs in a patient on methotrexate for inflammatory arthritis?
Given the drug-drug interaction, do you monitor more closely for methotrexate toxicity, counsel on symptoms of methotrexate toxicity, or avoid the combination altogether?
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Do you use NSAIDs in combination with methotrexate?
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2 Answers
Mednet MemberInvited Expert
Rheumatology · UTMB Health
Answered on
Yes, there is a theoretical drug-drug interaction here. However, I don’t avoid using the combination altogether. In certain patients, I am still using NSAIDs in combination with MTX. However, not uncommonly, the patient’s pharmacist may warn the patient of this potential interaction, and they would ...
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Mednet MemberInvited Expert
Rheumatology · Uniformed Services University of the Health Sciences (USUHS)
Answered on · Updated on
I agree 100% with Dr. @Dr. First Last. We also need to remember that the drug interactions between NSAIDs and MTX were with high doses used in oncology. Numerous studies looking at RA low-dose MTX are not associated with increasing MTX levels, such as Combe et al., PMID 7788170 and Hübner et al., PM...
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