Can I take naproxen short term while on low dose of methotrexate?

[Argyle103]

I have inflammatory arthritis. After a recent virus I have very painful hip joints.I am on 15mg methotrexate weekly

Can I take naproxen short term to help with inflammation?

My ESR reading is high

[Bootoo]

You need to speak to your doctor or rheumy team as we cannot give medical advise. Hope you feel better soon.

[Argyle103 in reply to Bootoo]

Thank you...on holiday abroad for a week...little access to GP back home.

[Madmusiclover in reply to Argyle103]

could you ask a pharmacist? As far as I know painkillers are not contraindicated with metho but I’m not medically qualified. Could you see what the patient leaflet on each says? You can find them on line.

[Argyle103 in reply to Madmusiclover]

Thank you. Will email my GP...seem to think it's ok short term.

[nomoreheels]

Hiya Argyle103, welcome. If you’re prescribed naproxen then that’s what they are intended for, to bring down inflammation. If you don’t have a prescription go to the nearest pharmacy & see if they can help. Remember you should also have a PPI (eg omeprazole) as well to protect your stomach.

I’ve been on MTX a long while & have always taken an NSAID alongside, so long term. Naproxen was one of my first & have had 5 if not 6 different ones over 15 years & before that for another condition.

I hope it’s not spoiling your holiday & you’re more comfortable soon.

[Argyle103 in reply to nomoreheels]

My first reply seems to have disappeared....so great with technology!I checked with pharmacist in Spain and am taking this for a few days. Hopefully this inflammatory bout is short-lived. Also have appointment with physio and GP on my return.

Thank you ... reassuring to have your reply

[nomoreheels in reply to Argyle103]

It's fortunate you're in Spain as it saves you trying to find a private doctor & potentially being charged lots. The Pharmacists are more highly qualified than in the UK & can ‘diagnose & prescribe’ for more common & existing conditions, this is how nationals do it initially for more common ailments, rather than visit the GP. I was a resident a few years ago & did this on many an occasion, for visitors too.

I hope it brings down the inflammation promptly. If not don't be afraid to return, they may recommend a corticosteroid.

[Argyle103 in reply to nomoreheels]

Thank you. It does seem to be having a positive effect....great advice about the omeprazole too.

[Drmjl18 in reply to nomoreheels]

this sums up the position perfectly

[StormySeas]

Just to say I'm on a low dose MTX and am prescribed Naproxen to take as required. This is not to recommend you take it, but if it's an emergency it might help reassure you. I'm also prescribed Omeprazole to go with the Naproxen.

[Argyle103 in reply to StormySeas]

Thank you...this blog is amazing

[Sheila_G]

Only your rheumatologist can give you that information but I hope you get the answer soon.

[LondonLinda]

Good morning, I have been on 25mg methotrexate for a long while and my RA specialist has long prescribed NAPROXEN 1 x 500mg twice a day to take with it. I personally am very happy with it. Good luck

[greynot]

We're all different of course. In my case I take 20mg Mtx weekly (with folic acid the other days) and 500mg Naproxen twice a day, along with Lanzoprazole. My rheumy said I'd be better on Naproxen than Ibuprofen.I'm also on low dose gabapentin and plenty of paracetamol

[Whitegate in reply to greynot]

Hi. GREYNOT - what is low dose gabapentin please?

[greynot in reply to Whitegate]

I was started on the 'standard' regime on 300mg three times a day which knocked me out. So with advice from a senior oharmacist and with GP approval, I played around with the dose and know take 100mg three times a day. The standard capsules are 300mg, it was the pharmacist who suggested I ask for 100mg capsules on my prescription.

Any less than 3x100mg and I know about it!

[Whitegate in reply to greynot]

Thank youI'm on 300mg at night about 6 nights a week but want to reduce the frequency to minimise side effect

[greynot in reply to Whitegate]

Sounds like a plan. You need to decrease gradually as your body builds up a dependency. Good luck xx

[marie66 in reply to greynot]

Alongside methotrexate hydroxy and anti inflammatory, I find gabapentin helpful too and adjust doses according to pain levels. I work between 300-500 usually, my GP is aware and it works for me. M x

[greynot in reply to marie66]

Isn't it important to take control and find out what works for pain where we can. Of course with the knowledge of the GP or Rheumy

[Runrig01]

Naproxen is listed as an interaction with MTX. It apparently increases the risk of toxicity of MTX. It applies to all nsaids. Now it may be that it is at much higher doses, but it doesn’t make reference to dosage.

MTX interactions

[greynot in reply to Runrig01]

It's an interesting one, and I queried it with my rheumy, who said I'd be better off with 2 x 500mg Naproxen than 3 x 400mg ibuprofen. I'm on 20mg mtx

[JenniferW in reply to Runrig01]

Hi Maureen,

I've had this quoted to me by the GP, but my rheumy is very clear that naproxen is the recommended NSAID taken with a stomach protector like omeprazole. The interaction refers to the level of methotrexate taken by cancer patients which is far higher that any dose we are likely to be prescribed. It's extremely annoying that the warning does not specify the dose level for the interaction it just leads to arguments with health care providers. Why they can't talk to each other instead of using us as a go between is beyond me.

Jennifer

[Argyle103 in reply to JenniferW]

Worried about litigation...

[JenniferW in reply to Argyle103]

Yep

[Hidden]

I used to get toxicity all the time with naproxen/ diclofenac. I stopped taking both of them and feel tons better. I did start on Amitriptyline which has worked a treat (Fibro).I take Mtx and Sulfasalazine..

Cutting stress out has been the best thing for me. It can still floor me for a week. Moving house, medical retirement and sorting my money out (pensions/ benefits etc) was my solution… It has made the world of difference.

[Green230461]

I have been given naproxen whilst on methotrexate before, by my consultant

[Amandaazz]

You can, assuming they have been prescribed together, however, naproxen is a particularly horrible pain killer and is in the same family as ibruprofen. I would speak to pharmacist, if you are unsure, they the experts with drug interactions and how they effect your body.

[Argyle103]

Thank you

[Jan101050]

I had an accident 6 weeks ago resulting in compression fracture of L 1 and 2. Vertebrae. I have Psoriatic arthritis and take methotrexate. My biologic was stopped because it wasn’t controlling the inflammation. I was prescribed naproxen for the pain from the fracture for four weeks . When I asked if the prescription could be continued I was advised because I was taking methotrexate it would have to be stopped. To be honest with you I never felt better …apart from the pain from the injury ….no inflammation in joints , fingers no more like sausages etc. I do take Lansoprazol. Is this drug any worse than taking steroids ? I think I need to discuss with rheumy team .

[Argyle103 in reply to Jan101050]

Oh I hope you get this resolved. It did help my inflammation but has affected my stomach.... Maybe didn't get balance right with omeprazole. Appointment with Physio and GP when I get home. Thanks

[nomoreheels in reply to Argyle103]

Argyle, how did you take the naproxen & omeprazole? I'm wondering as it's affected your stomach if you've taken them the best way to avoid potential stomach problems. I take omeprazole before food & my NSAID after food, though you can take it with food if you prefer, but omeprazole works best taken before food.

[Argyle103 in reply to nomoreheels]

I am abroad just now and think maybe the dosage was wrong. Putting up with the pain and back to physio and rheumatoid helpline on Friday. Was taking them as you said. Thanks

[nomoreheels in reply to Argyle103]

Oh, that’s not good. Just as a comparison I used l take 500 mg twice a day. I hope the pain doesn't increase before you manage to speak to your team.

[Argyle103 in reply to nomoreheels]

Thanks...home tomorrow x