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Can I take Methotrexate and Ibuprofen together?

Guia de interação medicamentosa

Taking ibuprofen while on methotrexate can cause the levels of methotrexate in your blood to rise to dangerous levels. This significantly increases the risk of serious side effects, including damage to your bone marrow (which helps fight infection), kidney problems, and severe stomach or mouth ulcers.

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Por que isso acontece

Methotrexate is cleared from your body through the kidneys. Ibuprofen interferes with this process in two ways: it reduces blood flow to the kidneys and blocks the specific 'pumps' the kidneys use to flush methotrexate out. This causes the methotrexate to build up in your system.

Do not take ibuprofen (or other similar anti-inflammatory drugs like naproxen or aspirin) while taking methotrexate unless your specialist doctor has specifically told you to do so and is monitoring your blood tests closely. For pain relief, paracetamol is usually a safer alternative. If you have already taken both and feel unwell, or develop a sore throat, fever, or unusual bruising, contact your doctor immediately.

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Drug Interaction (Kidney/Blood)

Do not take ibuprofen while taking methotrexate unless specifically directed by your specialist. Ibuprofen can stop methotrexate from leaving your body, leading to a dangerous build-up and severe toxicity.

Pregnancy and Conception

Methotrexate causes severe birth defects and miscarriage. You must use effective contraception during treatment and for at least 6 months after stopping. This applies to both men and women.

Infection and Blood Disorders

Methotrexate can suppress your immune system and bone marrow. You must seek immediate medical help if you develop a sore throat, fever, mouth ulcers, or unexplained bruising/bleeding.

Úlceras estomacais ou sangramento

Evite o ibuprofeno se você já teve úlcera estomacal, perfuração ou sangramento, pois pode causar danos graves ao revestimento do estômago.

Gravidez (terceiro trimestre)

Não tome ibuprofeno se estiver grávida de mais de 6 meses, pois pode causar problemas graves no coração e nos rins do bebê e complicações durante o parto.

Asma

Do not take ibuprofen if you have asthma and have ever experienced wheezing, shortness of breath, or a runny nose after taking aspirin or other NSAIDs, as it can trigger a life-threatening asthma attack.

Álcool

You should strictly limit or avoid alcohol while taking methotrexate. Both alcohol and methotrexate can cause liver damage; using them together significantly increases the risk of serious liver toxicity. Your doctor will advise if a very small amount is permissible based on your blood tests.

It is best to avoid or strictly limit alcohol while taking ibuprofen. Combining alcohol with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen increases the risk of irritation to your stomach lining and can lead to stomach ulcers or bleeding.

Cafeína (Café, Chá, Refrigerante)

High intake of caffeine may reduce the effectiveness of methotrexate for some conditions like rheumatoid arthritis. If you notice your symptoms worsening, try to keep your caffeine intake consistent and moderate.

Produtos lácteos

Milk and other dairy products contain an enzyme called xanthine oxidase which can break down methotrexate before it is absorbed. If you are taking methotrexate tablets, it is best to avoid consuming large amounts of dairy at the same time as your dose to ensure you get the full benefit of the medicine.

Alimentação (Geral)

It is best to take ibuprofen with food or a glass of milk. This helps to protect your stomach lining and reduces the chance of indigestion or stomach upset.

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Taking multiple medicines? Our Verificador de Interações de Medicamentos helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Aviso Legal

Esta informação é apenas para fins educacionais gerais e não deve ser considerada como um substituto para aconselhamento médico profissional. Sempre consulte seu médico, farmacêutico ou outro profissional de saúde qualificado antes de tomar decisões sobre seus medicamentos. As circunstâncias individuais podem variar, e somente um profissional de saúde que conheça seu histórico médico pode fornecer orientações personalizadas.

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Histórico do artigo

As informações nesta página são escritas e revisadas por clínicos qualificados.

  • 25 Jan 2026 | Publicado originalmente
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