Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Introduction: There is ongoing debate about the clinical significance of the Drug-Drug Interaction (DDI) between low-dose methotrexate (LD-MTX) and the short-term use of non-steroidal anti-inflammatory drugs (NSAIDs), and clear guidance for DDI management is lacking. This review addresses this gap by providing a comprehensive overview of the current data on the DDI between LD-MTX and NSAIDs, to offer guidance on DDI management during short-term analgesic use.
Areas Covered: To explore the pharmacokinetic and pharmacodynamic aspects of the DDI between LD-MTX (≤30 mg weekly) and NSAIDs for short-term analgesic use (≤14 days), two literature searches were conducted in PubMed in May 2024. NSAIDs have minimal impact on MTX pharmacokinetics, with only minor increases in MTX clearance observed in two out of ten studies. Based on the available evidence, it seems unlikely that NSAIDs substantially increase the risk of adverse events when co-administered with LD-MTX, particularly when used short-term.
Expert Opinion: In our opinion, no additional safety monitoring is required during short-term NSAID use in patients using LD-MTX in the absence of risk factors. In the presence of risk factors, i.e. renal insufficiency, dosage MTX > 20 mg/week, diabetes mellitus, dehydration, and use of acetylsalicylic acid in analgesic dose, DDI management should be individualized.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1080/17425255.2025.2546127 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Real-World Polypharmacy and Drug-Drug Interactions in a Large Cohort of Direct Oral Anticoagulant Users With Atrial Fibrillation.
Clin Ther
September 2025
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. Electronic address:
Purpose: Despite their promising safety profile, use of direct oral anticoagulants (DOACs) presents challenges, particularly concerning polypharmacy and potential drug-drug interactions (DDIs). This study aimed to investigate real-world effects of polypharmacy and DDIs among DOAC users, focusing on patients with atrial fibrillation (AF).
Methods: A retrospective cohort analysis was conducted using administrative health care data from the Caserta Local Health Unit (2012-2020).
Are We Considering All the Potential Drug-Drug Interactions in Women's Reproductive Health? A Predictive Model Approach.
Pharmaceutics
August 2025
IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe, Av. Fernando Abril Martorell 106, Torre A, Planta 1, 46026 Valencia, Spain.
Drug-drug interactions (DDIs) may occur when two or more drugs are taken together, leading to undesired side effects or potential synergistic effects. Most clinical effects of drug combinations have not been assessed in clinical trials. Therefore, predicting DDIs can provide better patient management, avoid drug combinations that can negatively affect patient care, and exploit potential synergistic combinations to improve current therapies in women's healthcare.
View Article and Find Full Text PDFRosuvastatin PBPK Modeling: Incorporating Liver Concentrations and Effects of Ethnicity, Genetic Polymorphisms, Lactone Formation, DDI and Pregnancy.
CPT Pharmacometrics Syst Pharmacol
August 2025
Department of Pharmaceutics, University of Washington, Seattle, WA, USA.
Rosuvastatin (RSV), a potent HMG-CoA reductase inhibitor, is widely used for the management of hyperlipidemia and prevention of cardiovascular disease. Its absorption and disposition are primarily transporter-mediated, involving intestinal absorption by OATP2B1 and efflux by BCRP; hepatic uptake by OATP1B1, OATP1B3, OATP2B1, and NTCP; and biliary excretion by BCRP and MRP2. Given its minimal metabolism, RSV serves as a model substrate for transporter-based drug absorption, disposition, and DDI studies.
View Article and Find Full Text PDFOptimization of In Vitro CYP3A4 TDI Assay Conditions and Use of Derived Parameters for Clinical DDI Risk Assessment Using Static and Dynamic Models.
AAPS J
August 2025
Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Grenzacherstrasse 124, F. Hoffmann-La Roche Ltd, CH-4070, Basel, Switzerland.
Cytochrome P450 3A4 (CYP3A4) is a key target for time-dependent inhibition (TDI) assessment during drug development. However, translating in vitro TDI data to in vivo drug-drug interaction (DDI) risk remains challenging due to the acknowledged overestimation when incorporating in vitro kinetics in predictive models. We investigated different in vitro TDI assay conditions in human liver microsomes (HLM) and evaluated their impact on the predictive accuracy for CYP3A4-related DDI for 32 marketed drugs.
View Article and Find Full Text PDFEvaluation of the drug-drug interaction between low-dose methotrexate and short-term use of non-steroidal anti-inflammatory drugs.
Expert Opin Drug Metab Toxicol
August 2025
Department of Pharmacy, Tergooi Medical Centre, Hilversum, The Netherlands.
Introduction: There is ongoing debate about the clinical significance of the Drug-Drug Interaction (DDI) between low-dose methotrexate (LD-MTX) and the short-term use of non-steroidal anti-inflammatory drugs (NSAIDs), and clear guidance for DDI management is lacking. This review addresses this gap by providing a comprehensive overview of the current data on the DDI between LD-MTX and NSAIDs, to offer guidance on DDI management during short-term analgesic use.
Areas Covered: To explore the pharmacokinetic and pharmacodynamic aspects of the DDI between LD-MTX (≤30 mg weekly) and NSAIDs for short-term analgesic use (≤14 days), two literature searches were conducted in PubMed in May 2024.