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Methotrexate and NSAID — GPhC CRA MCQ

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ModerateDrug InteractionsMethotrexate and NSAIDGPhC CRA

A patient taking weekly low-dose methotrexate asks to buy ibuprofen for a painful shoulder. He also has stage 3 chronic kidney disease. What is the most important interaction to flag?

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Correct answer: C — NSAIDs can increase methotrexate toxicity risk, especially with renal impairment

NSAIDs can reduce renal elimination of methotrexate and increase toxicity risk. Renal impairment increases concern, so safer analgesia and prescriber advice should be considered. The other options either delay appropriate care, use an unsuitable medicine, or miss the main safety issue.

Reference: BNF