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Methotrexate and high-dose aspirin — GPhC CRA MCQ

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HardDrug InteractionsMethotrexate and high-dose aspirinGPhC CRA

A 57-year-old man takes methotrexate weekly for psoriasis and is prescribed high-dose aspirin for suspected pericarditis by an out-of-hours clinician. He has eGFR 52mL/min/1.73m2. What is the most important interaction to flag?

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Correct answer: A — High-dose aspirin can increase methotrexate toxicity risk

NSAIDs and high-dose aspirin can reduce methotrexate clearance and increase toxicity risk, particularly with renal impairment or higher methotrexate doses. Low-dose antiplatelet aspirin is a different risk context. The prescription should be reviewed and monitoring considered.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment