Thiazides Methotrexate

Drugs that may be affected by NSAIDs include the following Aminoglycosides, anticoagulants, ACE inhibitors, beta blockers, cyclosporine, dextromethorphan, digoxin, dipyridamole, hydantoins, lithium, loop diuretics, methotrexate, penicillamine, potassium-sparing diuretics, sympathomimetics, theophylline, thiazide diuretics. 

Clinically important, potentially hazardous interactions with aceclofenac, acetazolamide, acitretin, bendroflumethiazide, benzthiazide, chlorothiazide, chlorthalidone, cocoa, desvenlafaxine, etoricoxib, fluoxetine, guarana, haloperidol, hydrochlorothiazide, hydroflumethiazide, indapamide, insulin detemir, insulin glulisine, meperidine, mesoridazine, methotrexate, methyclothiazide, metolazone, olmesartan, pegfilgrastim, phenylbutazone, polythiazide, quinethazone, rocuronium, rofecoxib, sibutramine, sulpiride, tenoxicam, thiazides, trichlormethiazide, valdecoxib, xipamide, zofenopril, zuclopenthixol... 

Some very limited evidence suggests that triamterene may possibly increase the bone marrow suppressive effects of methotrexate. It seems doubtful if thiazides interact adversely. 

A study in 9 patients found that neither furosemide nor hydroflumethiazide had any effect on the clearance of methotrexate in the urine. However, a study in women with breast cancer, treated with methotrexate, cyclophosphamide and fluorouracil found that the concurrent use of a thiazide diuretic appeared to increase the myelosuppressant effects, but it is not clear which of the antineoplastics might have been affected. ... 

Drug interactions ibuprofen affects the antihypertensive effect of ACE inhibitors, reduces the natriuretic effects of furosemide and thiazides, elevates the plasma lithium level by reducing renal lithium clearance, enhances the toxicity of methotrexate, and affects prothrombin time. 

---