1 interaction related to 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.
