Описание
Ibuprofen reduces methotrexate clearance and can cause severe methotrexate toxicity including life-threatening bone marrow suppression.
Механизм
Ibuprofen inhibits renal prostaglandin synthesis, reducing renal blood flow and tubular secretion of methotrexate; it also competes for organic anion transporters involved in methotrexate excretion.
Клиническое значение
Fatal cases of methotrexate toxicity have been reported when NSAIDs were used concurrently; even low-dose MTX regimens carry risk.
Тактика ведения
Avoid combination; monitor CBC, renal function, and MTX levels closely if unavoidable. Withhold ibuprofen for 48 h before and after MTX dose.
Медицинский отказ от ответственности
This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.