Drug Interaction between Ibuprofen and Methotrexate

Ibuprofen is an NSAID (nonsteroidal anti-inflammatory drug) used as an analgesic, antipyretic and antiinflammatory agent.
Methotrexate is used for the treatment of cancers of the breast, skin, lung, etc. It is also employed in the management of rheumatoid arthritis.

The concomitant use of both drugs can lead to a major drug interaction. This is because Ibuprofen, as an NSAID, interferes with the renal elimination of Methotrexate by displacing it from binding sites. Hence, increasing the toxicity of Methotrexate. The major toxicity effects include bone marrow suppression and nephrotoxicity, accompanied by nausea, vomiting, diarrhea, stomatitis, sore throat, bleeding, jaundice, dark urine, swelling of the extremities, etc.

This is considered a major drug interaction in which an alternative is strongly advised, else, very close monitoring is needed.

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