Can I take Aspirin and Methotrexate together?
Drug interaction guide
Originally published 24 Jan 2026
Meets Patient’s editorial guidelines
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Taking aspirin with methotrexate can significantly increase the levels of methotrexate in your blood. This can lead to serious side effects, including damage to your bone marrow (which helps fight infection), kidney problems, and severe stomach or mouth ulcers.
Why this happens
Aspirin interferes with how your kidneys remove methotrexate from your body. It also 'bumps' methotrexate off the proteins in your blood that normally keep it inactive, leaving more of the active drug to cause potential harm.
What you should do
Do not take aspirin (including low-dose 'baby' aspirin) while taking methotrexate unless your specialist doctor has specifically told you to do so. If you need pain relief, paracetamol is usually a safer choice. If you are already taking both, contact your doctor immediately if you notice unusual bruising, bleeding, a sore throat, or mouth ulcers.
Important precautions
Pregnancy and conception
Methotrexate causes severe birth defects. Both men and women must use effective contraception during treatment and for at least 6 months after stopping. Stop immediately and see a doctor if pregnancy is suspected.
Asthma
Do not take aspirin if you have a history of asthma triggered by aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs), as it can cause a life-threatening asthma attack.
Infection and blood disorders - methotrexate
Seek urgent medical attention for signs of infection (fever, sore throat) or unexplained bruising/bleeding. Methotrexate can severely suppress your immune system and bone marrow.
Food and drink warnings
Alcohol
You should strictly limit or avoid alcohol while taking methotrexate. Both alcohol and methotrexate can stress the liver; combining them significantly increases your risk of serious liver damage (cirrhosis or scarring).
Caffeine (Coffee, Tea, Cola)
High amounts of caffeine may reduce how well methotrexate works for some conditions like rheumatoid arthritis. Try to keep your intake of coffee, tea, and caffeinated soft drinks consistent and moderate.
Using other medicines?
Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.
Disclaimer
This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.
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Article history
The information on this page is written and peer reviewed by qualified clinicians.
Article also available in English, German, Spanish, French, Italian, Portuguese, Hindi, Hebrew, Arabic, and Swedish.
24 Jan 2026 | Originally published

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