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Methotrexate and NSAID — GPhC CRA MCQ

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ModerateDrug InteractionsMethotrexate and NSAIDGPhC CRA

A 59-year-old woman takes methotrexate weekly for psoriasis. She asks to buy naproxen for back pain and says her renal function was borderline at the last review. What is the most important interaction to flag?

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Correct answer: D — Naproxen may increase methotrexate toxicity risk

NSAIDs can reduce renal clearance of methotrexate and increase toxicity risk, especially at higher methotrexate doses or impaired renal function. Although some patients use NSAIDs under specialist supervision, OTC supply requires caution and review. The patient should be counselled on toxicity symptoms. The other options do not describe the clinically important concern.

Reference: BNF