methotrexate
2 interactions related to methotrexate
methotrexate + folate
Methotrexate works by inhibiting dihydrofolate reductase, depleting active folate and causing GI, mucosal, and hepatic side effects. Folic acid supplementation reduces those side effects by 26-77% without compromising efficacy, but must be timed correctly to avoid blunting the drug's action.
methotrexatefolatefolic acidrheumatoid arthritisdihydrofolate reductaseside effectssupplementationtiming
methotrexate + nsaids
NSAIDs reduce renal blood flow through prostaglandin inhibition and compete with methotrexate at renal tubular transporters, decreasing methotrexate clearance and raising serum levels. The risk is greatest with high-dose methotrexate or pre-existing renal impairment, where the combination can precipitate myelosuppression, mucositis, hepatotoxicity, and acute kidney injury.
methotrexatensaidsibuprofennaproxenkidneymyelosuppressiondrug interactionrenal toxicity