Acunivive 90 Injection System and Methotrexate

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Ketorolac may increase the blood levels and side effects of methotrexate. You may be more likely to experience this interaction if you have kidney disease or are receiving a high dose of methotrexate. The risk may be less if you are using methotrexate once a week to treat certain forms of arthritis. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor immediately if you develop symptoms of potentially serious side effects of methotrexate such as mouth ulcers or sores; vomiting; diarrhea; rash; loss of appetite; joint pain or swelling; yellow discoloration of skin and eyes; dark urine; shortness of breath; dry cough; paleness; dizziness or fainting; unusual bruising or bleeding; seizures; infection; and flu-like symptoms (fever, chills, body aches, sore throat, muscle weakness). It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR CLOSELY: Coadministration with nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the plasma concentrations and toxicities of methotrexate. The proposed mechanism is NSAID inhibition of the renal elimination of methotrexate and its metabolite, 7-hydroxymethotrexate, although data from pharmacokinetic studies are inconsistent and conflicting. Displacement of methotrexate binding to serum albumin by certain NSAIDs may also play a secondary role. Unexpectedly severe and sometimes fatal bone marrow suppression, aplastic anemia, gastrointestinal toxicity, and nephrotoxicity have been reported during concomitant administration of methotrexate with NSAIDs. The risk is greatest in patients receiving high dosages of methotrexate and those with renal impairment. In clinical studies, methotrexate at dosages of 7.5 to 15 mg/week has been used without apparent problems in patients with rheumatoid arthritis who also received constant dosage regimens of NSAIDs. However, there have been occasional reports of stomatitis, pneumonitis, bone marrow toxicity, and fatality in patients receiving low-dose weekly methotrexate with daily NSAIDs.

MANAGEMENT: NSAIDs should generally not be administered prior to or concomitantly with high dosages of methotrexate, such as those used to treat osteosarcoma. Caution should be exercised when NSAIDs are administered concomitantly with lower dosages of methotrexate. Close monitoring for signs and symptoms of bone marrow suppression, nephrotoxicity, and hepatotoxicity is recommended during treatment. Patients should be advised to contact their physician if they develop stomatitis, nausea, vomiting, diarrhea, rash, anorexia, jaundice, dark urine, dry cough, shortness of breath, and/or signs and symptoms of myelosuppression such as pallor, dizziness, fatigue, lethargy, fainting, easy bruising or bleeding, fever, chills, sore throat, body aches, and other influenza-like symptoms. Patients should also be counseled to avoid any other over-the-counter NSAID products.

Acunivive 90 Injection System

Generic Name: ketorolac

Brand name: Sprix, Toradol

Synonyms: Ketorolac (nasal), Ketorolac (Nasal)

What is Acunivive 90 Injection System?

Methotrexate

Generic Name: methotrexate

Brand name: Otrexup, Rasuvo, Rheumatrex Dose Pack, Trexall, Xatmep, Methotrexate Sodium, Preservative Free

Synonyms: n.a.

What is Methotrexate?