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Methotrexate and NSAID — GPhC CRA MCQ

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ModerateDrug InteractionsMethotrexate and NSAIDGPhC CRA

A patient taking methotrexate weekly for psoriasis asks to buy naproxen for dental pain. He has mild chronic kidney disease and no recent blood tests. What is the most important interaction to flag?

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Correct answer: C — NSAIDs can increase methotrexate toxicity risk

NSAIDs can reduce renal clearance of methotrexate and increase toxicity risk, particularly with renal impairment or higher methotrexate doses. Dental pain should be assessed and safer analgesic options considered. Recent monitoring status is important because methotrexate toxicity can be serious. The interaction does not remove NSAID gastrointestinal risk.

Reference: BNF