Is Salicylates (e.g., Willow Bark) Safe with methotrexate?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Avoid salicylate-containing supplements such as willow bark. If coadministration cannot be avoided, monitor closely for methotrexate adverse reactions.
Why this interaction occurs
Salicylates are highly protein-bound and act as weak acids, both mechanisms of which can increase methotrexate plasma concentrations, raising the risk of severe adverse reactions including organ toxicity.
Evidence
Evidence level: strong.
Data source
FDA Drug Label
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 499,559 reports mentioning methotrexate. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the methotrexate + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All Salicylates (e.g., Willow Bark) interactions → · All methotrexate interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.