Drug interactions
Aspirin rectal + Methotrexate
Severity: Major
Aspirin rectal and Methotrexate: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Systemically absorbed aspirin can reduce methotrexate clearance and increase toxicity such as myelosuppression, mucositis and kidney injury. The risk is greatest with high-dose methotrexate and in renal impairment.
What this interaction means in plain words
Aspirin rectal and Methotrexate can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Salicylates reduce renal tubular secretion of methotrexate and displace it from plasma proteins.
What to do
Avoid with high-dose methotrexate. With low-dose methotrexate, monitor blood counts and renal function and reduce the methotrexate dose if toxicity appears.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Methotrexate
- Acitretin + Methotrexate Contraindicated
- Adenovirus types 4 and 7 live + Methotrexate Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Methotrexate Contraindicated
- Ketorolac + Methotrexate Contraindicated
- Measles mumps and rubella vaccine live + Methotrexate Contraindicated
- Measles mumps and rubella vaccine + Methotrexate Contraindicated
Frequently asked questions
Can I take Aspirin rectal with Methotrexate?
MediHelp rates the interaction as major. Aspirin rectal and Methotrexate can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Systemically absorbed aspirin can reduce methotrexate clearance and increase toxicity such as myelosuppression, mucositis and kidney injury. The risk is greatest with high-dose methotrexate and in renal impairment.
How serious is the interaction between Aspirin rectal and Methotrexate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid with high-dose methotrexate. With low-dose methotrexate, monitor blood counts and renal function and reduce the methotrexate dose if toxicity appears.
What other medicines interact with Methotrexate?
MediHelp also lists interactions of Methotrexate with, for example, Acitretin, Adenovirus types 4 and 7 live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Methotrexate page.
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