What the FDA labels say about taking them together
Diclofenac and methotrexate
Diclofenac's FDA label of February 11, 2025 names methotrexate in its drug interactions (prescription label) section; methotrexate's label does not name diclofenac itself but warns about its class (NSAIDs (nonsteroidal anti-inflammatory drugs)). The diclofenac label: “Concomitant use of NSAIDs and methotrexate may increase the risk for methotrexate toxicity.”
Check it at the source: the diclofenac FDA label on DailyMed (effective February 11, 2025, Haleon US Holdings LLC); the methotrexate FDA label on DailyMed (effective May 27, 2026, Accord Healthcare Inc.).
What does the diclofenac label say about methotrexate?
Diclofenac label, drug interactions (prescription label)Methotrexate NSAIDs have been reported to competitively inhibit methotrexate accumulation in rabbit kidney slices.
Licart label (IBSA Pharma Inc., April 2, 2026), drug interactionsMethotrexate Clinical Impact: Concomitant use of NSAIDs and methotrexate may increase the risk for methotrexate toxicity (…). Intervention: During concomitant use of LICART and methotrexate, monitor patients for methotrexate toxicity.
Source: FDA drug label (Licart, NDA206976), IBSA Pharma Inc., effective April 2, 2026 (SPL set 851c8b39-6056-4bbc-812e-b9b13977c1ac), via openFDA
Source: FDA drug label (Flector, NDA021234), IBSA Pharma Inc., effective October 21, 2025 (SPL set 1f19a016-c4fc-43c5-9990-e5f2e2776a82), via openFDA
Source: FDA drug label (Zipsor, NDA022202), Assertio Specialty Pharmaceuticals LLC, effective March 1, 2026 (SPL set ed2a8868-78eb-47b8-8f46-0f70e2891e07), via openFDA
Source: FDA drug label (Voltaren Arthritis Pain), Haleon US Holdings LLC, effective February 11, 2025 (SPL set 30a94282-0892-442a-aa10-6525cbd4fe88), via openFDA; the full label on DailyMed
What does the methotrexate label say about diclofenac?
Methotrexate's label does not name diclofenac itself; it warns about its class (NSAIDs (nonsteroidal anti-inflammatory drugs)):
Methotrexate label, boxed warningUnexpectedly severe (sometimes fatal) bone marrow suppression, aplastic anemia, and gastrointestinal toxicity have been reported with concomitant administration of methotrexate (usually in high dosage) along with some nonsteroidal anti-inflammatory drugs (NSAIDs) [see Warnings and Precautions (5.1) and Drug Interactions(7.1) ].
Methotrexate label, drug interactionsConcomitant administration of some NSAIDs with high dose methotrexate therapy has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and gastrointestinal toxicity [see Warnings and Precautions (5.1) ].
Source: FDA drug label (Methotrexate), Accord Healthcare Inc., effective May 27, 2026 (SPL set 874c7f43-a3be-4236-89cc-24c44e3c5813), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Diclofenac | Methotrexate | |
|---|---|---|
| Labeled for | Pain, Osteoarthritis, Rheumatoid arthritis, Migraine | Rheumatoid arthritis, Psoriasis, Leukemia, lymphoma and myeloma, Breast cancer |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.0619 per tablet 75 mg tablet | $0.158 per tablet 2.5 mg tablet |
| Shortage now | A presentation being discontinued | In shortage |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once