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Aspirin + methotrexate is a combination of two small molecule drugs, each with distinct mechanisms of action. Aspirin (acetylsalicylic acid) is a non-selective cyclooxygenase (COX) inhibitor used for its analgesic, antipyretic, anti-inflammatory, and antiplatelet effects. Methotrexate is an antimetabolite and disease-modifying antirheumatic drug (DMARD) that inhibits dihydrofolate reductase, interfering with folic acid metabolism to exert immunosuppressive and anti-inflammatory effects. This combination may be encountered in clinical practice for patients with inflammatory arthritis or other autoimmune conditions requiring both agents; however, the concurrent use increases the risk of methotrexate toxicity due to reduced renal clearance and potential additive hepatotoxicity. The combination should only be used under close medical supervision with appropriate monitoring[1][2][5][8].
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