Methotrexate and Misoprostol Interaction
Drug interaction information between Methotrexate and Misoprostol.
Methotrexate and Misoprostol have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Methotrexate and Misoprostol. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
The diclofenac in this medicine can stop your body from getting rid of methotrexate properly. This can cause methotrexate to build up to harmful levels in your blood.
What To Do
Your doctor should monitor your blood levels and kidney function closely for signs of toxicity.
FDA Label Information
Methotrexate Clinical Impact: Concomitant use of NSAIDs and methotrexate may increase the risk for methotrexate toxicity (e.g., neutropenia, thrombocytopenia, renal dysfunction). Intervention: During concomitant use of diclofenac sodium/misoprostol and methotrexate, monitor patients for methotrexate toxicity.
Methotrexate Also Interacts With
- Celecoxib moderate
- Diflunisal moderate
- Indomethacin moderate
- Mefenamic Acid moderate
- Meloxicam moderate
Misoprostol Also Interacts With
- Diclofenac moderate
- Diflunisal moderate
- Furosemide minor
- Aspirin minor
- Propranolol minor
Frequently Asked Questions
Can I take Methotrexate and Misoprostol together?
This is a moderate interaction. Your doctor should monitor your blood levels and kidney function closely for signs of toxicity.
How serious is the interaction between Methotrexate and Misoprostol?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Methotrexate and Misoprostol interact?
The diclofenac in this medicine can stop your body from getting rid of methotrexate properly. This can cause methotrexate to build up to harmful levels in your blood.
Understanding the Methotrexate and Misoprostol Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Methotrexate belongs to the Disease-Modifying Antirheumatic Drug (DMARD) class and Misoprostol belongs to the Prostaglandin E1 Analog class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: The diclofenac in this medicine can stop your body from getting rid of methotrexate properly. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Methotrexate has 38 total documented interactions on file in this dataset, and Misoprostol has 12. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Your doctor should monitor your blood levels and kidney function closely for signs of toxicity. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Methotrexate or Misoprostol based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.