Methotrexate (MTX) is a nonbiological disease-modifying antirheumatic drug that has shown both a good control of clinical disease\r\nand a good safety. Usually drug-drug interactions (DDIs) represent the most limiting factor during the clinical management of any\r\ndisease, in particular when several drugs are coadministered to treat the same disease. In this paper, we report the interactions\r\namong MTX and the other drugs commonly used in the management of rheumatoid arthritis. Using Medline, PubMed, Embase,\r\nCochrane libraries, and Reference lists,we searched for the articles published until June 30, 2012, andwe reported the most common\r\nDDIs between MTX and antirheumatic drugs. In particular, clinically relevant DDIs have been described during the treatment\r\nwith MTX and NSAIDs, for example, diclofenac, indomethacin, or COX-2 inhibitors, and between MTX and prednisone or\r\nimmunosuppressant drugs (e.g., leflunomide and cyclosporine). Finally, an increase in the risk of infections has been recorded\r\nduring the combination treatment with MTX plus antitumor necrosis factor-a agents. In conclusion, during the treatment with\r\nMTX, DDIs play an important role in both the development of ADRs and therapeutic failure.
Loading....