What the FDA labels say about taking them together
Methotrexate and sulindac
Sulindac's FDA label of December 20, 2024 names methotrexate in its drug interactions section; methotrexate's label does not name sulindac itself but warns about its class (NSAIDs (nonsteroidal anti-inflammatory drugs)).
Check it at the source: the methotrexate FDA label on DailyMed (effective May 27, 2026, Accord Healthcare Inc.); the sulindac FDA label on DailyMed (effective December 20, 2024, Epic Pharma, LLC).
What does the methotrexate label say about sulindac?
Methotrexate's label does not name sulindac 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
What does the sulindac label say about methotrexate?
Sulindac label, drug interactionsMethotrexate NSAIDs have been reported to competitively inhibit methotrexate accumulation in rabbit kidney slices.
Source: FDA drug label (SULINDAC), Epic Pharma, LLC, effective December 20, 2024 (SPL set 96c73bd2-4577-487d-a642-bd8f91e94c3a), 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
| Methotrexate | Sulindac | |
|---|---|---|
| Labeled for | Rheumatoid arthritis, Psoriasis, Leukemia, lymphoma and myeloma, Breast cancer | Osteoarthritis, Rheumatoid arthritis |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.158 per tablet 2.5 mg tablet | $0.189 per tablet 150 mg tablet |
| Shortage now | In shortage | No current entry |
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