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Anticoagulants eg, warfarin , aspirin, clopidogrel, corticosteroids eg, prednisone , direct factor xa inhibitors eg, rivaroxaban , heparin, prasugrel, or selective serotonin reuptake inhibitors ssris eg, fluoxetine because the risk of bleeding, including stomach bleeding, may be increased azole antifungals eg, itraconazole, voriconazole , bisphosphonates eg, risedronate , or probenecid because they may increase the risk of diclofenac s side effects rifamycins eg, rifampin because they may decrease diclofenac s effectiveness cyclosporine, lithium, methotrexate, other nsaids eg, ibuprofen , quinolones eg, ciprofloxacin , or tenofovir because the risk of their side effects may be increased by diclofenac angiotensin-converting enzyme ace inhibitors eg, enalapril or diuretics eg, furosemide, hydrochlorothiazide because their effectiveness may be decreased by diclofenac medicines that may harm the liver eg, acetaminophen, ketoconazole, isoniazid, certain medicines for hiv infection, certain antibiotics or seizure medicines because the risk of liver side effects may be increased.
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Do not use the preserved formulation of methotrexate for intrathecal or high-dose therapy because it contains benzyl alcohol.
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The unanswered question is how much more expensive it is to give a standard dose of methotrexate by the auto-injector compared to the same dose as an oral treatment, she noted.
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Clinical teratology counseling and consultation case report low dose methotrexate exposure in the early weeks of pregnancy.
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