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Methotrexate and NSAID — GPhC CRA MCQ

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ModerateDrug InteractionsMethotrexate and NSAIDGPhC CRA

A patient taking weekly methotrexate for psoriasis asks to buy naproxen for a sprained ankle. He has CKD stage 3. What is the most important interaction to flag?

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Correct answer: E — Naproxen may increase methotrexate toxicity risk, especially with renal impairment

NSAIDs can reduce renal elimination of methotrexate and increase toxicity risk, particularly with renal impairment or higher methotrexate exposure. Pharmacist assessment and prescriber advice are appropriate. Timing separation does not reliably remove the interaction.

Reference: BNF