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28 when using one of these agents concurrently with nsaids, extra monitoring and vigilance may be necessary to prevent lithium and methotrexate toxicity.
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caution is advised when methotrexate is administered concurrently, due to the possible enhancement of its toxicity as naproxen, like other nsaids, has been reported to reduce tubular secretion of methotrexate in an animal model.
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