JLE

Journal de Pharmacie Clinique

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Importance of dosage in adverse effects : methotrexate/non steroidal antiinflammatory drug Volume 18, issue 4, Décembre 1999

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Authors
Clinique rhumatologique et thérapeutique, CHU Dupuytren, 87042 Limoges.

Drug interaction between nonsteroidal antiinflammatory drugs (NSAID) with high dose of methotrexate (MTX) is well known : toxic hematologic effects of MTX could be increased by a concurrent administration of MTX-NSAID. NSAID are often co-administered with low dose of MTX ( 15 mg per week), for symptomatic treatment of rheumatoid arthritis (RA). Some of publications showed the apparition of an adverse side effect with the simultaneous use of MTX-NSAID in RA. Interaction between this two drugs could alter the pharmacokinetics of MTX : the review of literature usually showed the lack of alteration of different MTX pharmacokinetic parameters (absorption, bioavailibility, percentage of unbound fraction, area under the curve, half-life, rate of elimination), except for the co-administration of MTX-salicylates. Concomitant use of low dose of MTX with NSAID is possible in the treatment of RA. But this association requires a biological and a clinical monitoring.