Drug interactions
Meclofenamate + Methotrexate
Severity: Major
Meclofenamate and Methotrexate: major interaction.
Last updated
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
NSAIDs such as meclofenamate can raise and prolong methotrexate levels, and deaths from severe hematologic and gastrointestinal toxicity have been reported with high-dose methotrexate. The risk is greatest with high doses and impaired renal function.
What this interaction means in plain words
Meclofenamate 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
NSAIDs reduce renal perfusion and compete for tubular secretion, decreasing methotrexate renal clearance.
What to do
Avoid with high-dose methotrexate. With low-dose methotrexate, monitor blood counts and renal function and consider an alternative analgesic.
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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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 Meclofenamate with Methotrexate?
MediHelp rates the interaction as major. Meclofenamate 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. NSAIDs such as meclofenamate can raise and prolong methotrexate levels, and deaths from severe hematologic and gastrointestinal toxicity have been reported with high-dose methotrexate. The risk is greatest with high doses and impaired renal function.
How serious is the interaction between Meclofenamate 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 consider an alternative analgesic.
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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