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Methotrexate and NSAID — GPhC CRA MCQ

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ModerateDrug InteractionsMethotrexate and NSAIDGPhC CRA

A patient taking methotrexate 20 mg once weekly for psoriasis asks to buy diclofenac tablets for back pain. His renal function was borderline at the last review. He has no red flags for back pain. What is the most appropriate alternative?

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Correct answer: B — Paracetamol or topical analgesia after assessment

NSAIDs can reduce renal elimination of methotrexate and increase toxicity risk, especially at higher methotrexate doses or impaired renal function. Some patients may use NSAIDs under specialist advice, but self-purchase requires caution. Safer analgesia or prescriber advice should be considered.

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