MTX and taking NSAIDs ... Can they be taken together?

Firemanphil_39

I've just been reading donnas thread and read that MTX taken without NSAIDs... I've been popping diclofenac and naproxen along with my weekly meth dose for last 18 weeks....

Have I blundered?

I'm going to see if I can get some sort of private health care insurance quote... Not really happy with the scarcity of appointments... Their delays... Etc

donnas

It says on my MTX leaflet from rheumatology that you can take them if prescribed. The pharmacists I've all spoken to say you can't take NSAIDs with MTX! The offficial word on MTX and NSAIDs according to the British national formulary is that they increase MTX toxicity by reducing excretion.

So I'm playing safe for now until I get a definitive answer. I'm very sorry if I've worried you or anyone else, but the conflicting advice makes me cautious.

I was given my MTX prescription and left to get on with it, so I've not had a chance to speak to a rheumatology specialist about it yet (I hope to have access to a nurse soon), if you have access to someone like that maybe they could help you?

Good luck!

donnas

I'm sure the blood tests would show up any toxic effects, I agree. I'm just very cautious and two separate pharmacists have mentioned to me that I can't even take a nurofen for a headache. I'm just going by the book and checking with the pharmacist every time I buy any over the counter meds.

Keep getting the blood tests!

donnas

The pharmacists always seem happy to check things out for me, I've been pretty lucky! I mention methotrexate to them and they ask me if I'm getting my blood tests and go away and look things up without any bother. It's just one of those drugs that they are interested in, I reckon, due to the interactions. It was my pharmacist that told me to go to the doc with the yeast infection, I had no idea it was likely to be opportunistic til I asked her!

madwestie

Phil, i have been taking Etodolac(Lodine) which is a Cox 2 inhibitor ( a different sort of anti inflamatory) for about 6 years now and i have been taking MTX for about 4 years no one has ever said not to take them
I woud speak to your Gp and see what he has to say

Tracey

frogmorton

Hi Phil

get it checked out l would although this is the first l'd heard of it.

I didn't realise you could take two lots of anti-inflams either so you learn something new every day eh?

Love

toni xx

tillytop

Hi Phil

From my experience nsaids are commonly prescribed alongside mtx - although as you rightly say, it is highlighted on mtx package leaflet because taking them together can increase the toxicity of the meth. I have taken them together both times I have had meth and, having conducted a little (not very scientific) experiment over the past few days I have come to the conclusion that, for me, taking Diclofenac regularly alongside high dose mtx is a significant contributor to my constant nausea.

Like the others have said though, I was surprised to read that you are taking 2 prescription nsaids together and I think it really would be worth checking out your combination of meds with the doc.

Re private health iinsurance Phil - not wanting to burst your bubble but just to sound a note of caution and perhaps save you some hassle. I believe you will struggle to find any kind of private health insurance which will cover your arthritis. Health insurance companies do not like what they call "pre-existing conditions" and if you do find someone to cover you, at an affordable premium, I think you will find that they will exclude your arthritis and anything that could conceivably be associated with it. For example if you needed to be referred to someone for stomach trouble, the health insurance company would probably say that, because you take the drugs you do, and they are known to have the potential to cause stomach probs, the stomach trouble is related to the arthritis - so not covered!

What you could do is arrange to pay yourself to see a private consultant. Again though, a note of caution based on my own experience. If your main consultant is private you could find yourself paying for private prescriptions, blood tests, x-rays etc (even if carried out at the GP) and it can get frightently expensive very quickly. For me this was many years ago and I think it is perhaps easier these days to mix and match NHS and private. What I ended up doing, which worked well, was carrying on with my NHS treatment and paying to see one of the consultants privately once or twice a year. Cost for each appt was around £115 if I remember rightly but may be more now.

Hope some of my waffle has been helpful Phil - and good luck with it all.

Love Tillyxxx

keith1971

Hi Phil,

Just to add my 2 cents regarding the private consultants as I'm currently seeing someone.

Each visit costs £200, that's just for the consultation. Each X-ray is around £200 also (per body part). Full blood test was nearly £400! Private sulfa prescription was nearly £60, so like Tilly rightfully said, it can all add up pretty quickly!!!

I'm lucky that I was already covered by Bupa before the arthritis hit & so far have only had to pay £250 excess on my policy. I understand they're not keen on long term conditions but I've been told I should be covered until at least the end of the year - if not, I'll just join my current rheumatologists NHS practice as I've built up a good relationship with him & his bedside manner is relaxed yet informative.

Can't help with the drugs question though, I've resisted taking NSAIDs, preferring to try an alternative medicine route (ginger, tumeric, fish oils, diet etc).

All the best,

K.

Firemanphil_39

That's clearer... I did initially see my consultant privately, 200 quid. He took me on nhs... The bloods are quite expensive eh? Oh, I'm not taking the 2 NSAIDs together...

cthornley

2 NSAID 's together = definite no no!
NSAID & mtx absolutely fine as long as you are gettin regular blood monitoring which you should be anyway for the mtx alone.
I'm a stickler for monitoring what drugs can be taken with what as I've had locum's make serious mistakes before and know 1st hand of the infallibility of drs....I'm married to one!
All my drugs come with big red hazard warnings on the computer when my GP tries to prescribe them as they are very nasty toxic drugs Inc. The NSAIDs but they are fine when prescribed to battle this nasty disease and kept an eye on through monitoring to make sure they behave themselves and don't fall out too much!
Pharmacist's are right to check they have been prescribed together & have an awareness of the issues but it's not correct to say they shouldn't be.
Chrissie

skezier

Hi Phil,

I agree with Chrissy and have been on the both from the beginning. Its fine for me but there is an issue with the pair but I should think they will know that and your bloods would show any kind of problem. Hope your doing ok by the way? Cris x

tiggernut

Hi,
I never knew there was a problem taking both. I have been on Voltarol for over 20 years and MTX for about 3 maybe 4 can't remember. Nobody has ever said there was a problem. I don't seem to have any problems and assume it would show in the blood, but now I know I will be asking my rhuemy nurse when I next see her.