See the DrugPatentWatch profile for methotrexate

Yes, there are over-the-counter (OTC) medications that should be avoided or used with caution when taking methotrexate. Methotrexate is a disease-modifying antirheumatic drug (DMARD) used to treat conditions like rheumatoid arthritis, psoriasis, and certain types of cancer [1]. Concurrent use of certain medications can increase the risk of methotrexate-related side effects.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are often used to manage pain and inflammation [1][2]. However, NSAIDs can increase the risk of methotrexate-induced kidney damage and stomach ulcers [1]. Therefore, it is essential to use NSAIDs cautiously and under the guidance of a healthcare professional when taking methotrexate.

Probenecid, a medication used to treat gout, should also be avoided while on methotrexate, as it can increase methotrexate levels in the body, leading to toxicity [1].

Vitamin supplements, particularly folic acid, are often recommended to help manage methotrexate-related side effects [1]. However, high-dose folic acid supplements (greater than 1 mg per day) may reduce the effectiveness of methotrexate [1]. It is crucial to consult a healthcare provider to determine the appropriate folic acid dosage when taking methotrexate.

In summary, when taking methotrexate, it is essential to avoid or use specific OTC medications cautiously, such as NSAIDs and probenecid, and to consult a healthcare professional regarding folic acid supplementation.

Sources:
[1] Methotrexate. (2021). MedlinePlus. Retrieved from <https://medlineplus.gov/druginfo/meds/a68/pro>
[2] NSAIDs: Nonsteroidal Anti-Inflammatory Drugs. (2021). Arthritis Foundation. Retrieved from <https://www.arthritis.org/diseases/treatments/medication/aspirin-nsaid- COX-2-inhibitors/nsaid-basics>