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Naproxen and Methotrexate Interaction

Drug interaction information between Naproxen and Methotrexate.

Naproxen and Methotrexate have a documented moderate interaction in FDA labeling.

FDA drug labeling documents a moderate-severity interaction between Naproxen and Methotrexate. 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.

Drug A

Naproxen

Nonsteroidal Anti-Inflammatory Drug (NSAID)

Drug B

Methotrexate

Disease-Modifying Antirheumatic Drug (DMARD)

How They Interact

Naproxen can cause methotrexate to stay in your system longer, which increases the risk of harmful side effects like low blood cell counts or kidney problems.

What To Do

Your doctor should monitor you closely for signs of toxicity while you are taking both medications. Report any unusual symptoms like bruising or fatigue to your healthcare provider.

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 naproxen tablets or naproxen sodium tablets and methotrexate, monitor patients for methotrexate toxicity.

Methotrexate Also Interacts With

View all Methotrexate interactions →

Frequently Asked Questions

Can I take Naproxen and Methotrexate together?

This is a moderate interaction. Your doctor should monitor you closely for signs of toxicity while you are taking both medications. Report any unusual symptoms like bruising or fatigue to your healthcare provider.

How serious is the interaction between Naproxen and Methotrexate?

This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.

Why do Naproxen and Methotrexate interact?

Naproxen can cause methotrexate to stay in your system longer, which increases the risk of harmful side effects like low blood cell counts or kidney problems.

Understanding the Naproxen and Methotrexate Interaction

FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Naproxen belongs to the Nonsteroidal Anti-Inflammatory Drug (NSAID) class and Methotrexate belongs to the Disease-Modifying Antirheumatic Drug (DMARD) class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Naproxen can cause methotrexate to stay in your system longer, which increases the risk of harmful side effects like low blood cell counts or kidney problems. 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. Naproxen has 23 total documented interactions on file in this dataset, and Methotrexate has 38. 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 you closely for signs of toxicity while you are taking both medications. 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 Naproxen or Methotrexate 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.