Major
meloxicam × Methotrexate
NSAID, COX-2 preferential, oxicam derivative×Antimetabolites, folic acid analogues
Mechanism
NSAIDs reduce renal methotrexate clearance. At high oncologic doses: myelosuppression and mucositis. At low rheumatologic doses, risk is smaller but monitoring is needed.
Symptoms
Stomatitis, diarrhoea, falling leukocyte, platelet, and erythrocyte counts. Severe cases: fatal pancytopenia, nephrotoxicity.
Management
At oncologic methotrexate doses, the combination is not prescribed. At low rheumatologic doses, meloxicam is acceptable for a short course with blood count and creatinine monitoring every 1–3 months.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.