Does Aspirin Interact With Methotrexate?
If coadministration cannot be avoided, monitor closely for methotrexate adverse reactions when coadministered with: Oral antibiotics (including neomycin) Antifolate drugs (e.g., dapsone, pemetrexed, pyrimethamine and sulfonamides) Oral or intravenous penicillin or sulfonamide antibiotics Aspirin and other nonsteroidal anti- inflammatory drugs Hepatotoxic products Highly protein-bound drugs (e.g., oral anticoagulants, phenytoin, salicylates, sulfonamides, sulfonylureas, and tetracyclines) Prot…
Severity: Major
Severity basis: drug interactions section (keywords: avoid). Combining Aspirin (Antiplatelet / NSAID) and Methotrexate (Antimetabolite DMARD) is classified as a major interaction.
What to Do
The label advises avoiding this combination or using it only under close medical supervision. Talk to your prescriber or pharmacist before combining them.
How This Interaction Works
Interactions like this one can happen when two medicines have overlapping effects, or when one changes how the other is absorbed, broken down, or cleared from the body. Aspirin is a antiplatelet / nsaid and Methotrexate is a antimetabolite dmard; together they are documented as a major interaction. How much this matters depends on your dose, your other medications, and your overall health.
If You Take Both Medications
If you have been prescribed both Aspirin and Methotrexate, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.
From the FDA Label
If coadministration cannot be avoided, monitor closely for methotrexate adverse reactions when coadministered with: Oral antibiotics (including neomycin) Antifolate drugs (e.g., dapsone, pemetrexed, pyrimethamine and sulfonamides) Oral or intravenous penicillin or sulfonamide antibiotics Aspirin and other nonsteroidal anti- inflammatory drugs Hepatotoxic products Highly protein-bound drugs (e.g., oral anticoagulants, phenytoin, salicylates, sulfonamides, sulfonylureas, and tetracyclines) Prot…
Source: FDA structured product labeling (set_id 04a95db9-a124-4b97-bd71-1c37a6b3b0c8).
Check these against your full medication list in our free Interaction Checker
Frequently Asked Questions
Can you take Aspirin and Methotrexate together?
Aspirin and Methotrexate have a documented major interaction. The label advises avoiding this combination or using it only under close medical supervision. Talk to your prescriber or pharmacist before combining them.
How serious is the Aspirin and Methotrexate interaction?
It is classified as a major interaction, based on the FDA label's drug interactions section (keywords: avoid). A major interaction can cause serious harm and often calls for a change in therapy or close monitoring.
What should I do if I'm taking both Aspirin and Methotrexate?
If you have been prescribed both Aspirin and Methotrexate, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.
This information is educational — not medical advice.
This page is provided for general educational purposes and summarizes publicly available data from sources such as the U.S. Food & Drug Administration. It is not a substitute for the judgment of a licensed clinician and should not be used to start, stop, or change any medication. It may be incomplete or out of date, and individual circumstances vary. Always talk with your prescriber or pharmacist about your specific medications and health conditions. If you think you may have a medical emergency, call 911.
Other Aspirin Interactions
- Aspirin + Celecoxib(contraindicated)
- Aspirin + Indomethacin(contraindicated)
- Aspirin + Ketorolac(contraindicated)
- Aspirin + Meloxicam(contraindicated)
- Aspirin + Naproxen(contraindicated)
- Aspirin + Fluoxetine(major)
- Aspirin + Ibuprofen(major)
- Aspirin + Montelukast(major)
- Aspirin + Alendronate(moderate)
- Aspirin + Citalopram(moderate)
- Aspirin + Desvenlafaxine(moderate)
- Aspirin + Edoxaban(moderate)
- Aspirin + Escitalopram(moderate)
- Aspirin + Methylprednisolone(moderate)
- Aspirin + Paroxetine(moderate)
- Aspirin + Rivaroxaban(moderate)
- Aspirin + Spironolactone(moderate)
- Aspirin + Trazodone(moderate)
- Aspirin + Valproic Acid(moderate)
- Aspirin + Apixaban(minor)
- Aspirin + Atenolol(minor)
- Aspirin + Atomoxetine(minor)
- Aspirin + Dexamethasone(minor)
- Aspirin + Diclofenac(minor)
- Aspirin + Duloxetine(minor)
- Aspirin + Enoxaparin(minor)
- Aspirin + Finasteride(minor)
- Aspirin + Furosemide(minor)
- Aspirin + Levothyroxine(minor)
- Aspirin + Nitroglycerin(minor)
- Aspirin + Oseltamivir(minor)
- Aspirin + Sertraline(minor)
- Aspirin + Sildenafil(minor)
- Aspirin + Tadalafil(minor)
- Aspirin + Venlafaxine(minor)
- Aspirin + Verapamil(minor)
- Aspirin + Warfarin(minor)
Other Methotrexate Interactions
- Methotrexate + Folic Acid(major)
- Methotrexate + Phenytoin(major)
- Methotrexate + Adalimumab(moderate)
- Methotrexate + Celecoxib(moderate)
- Methotrexate + Furosemide(moderate)
- Methotrexate + Hydroxychloroquine(moderate)
- Methotrexate + Indomethacin(moderate)
- Methotrexate + Meloxicam(moderate)
- Methotrexate + Naproxen(moderate)
- Methotrexate + Cyclosporine(minor)
- Methotrexate + Lansoprazole(minor)
- Methotrexate + Ondansetron(minor)
- Methotrexate + Pantoprazole(minor)