Drug & supplement interaction

Inositol Nicotinate + Methotrexate

Methotrexate brand names: Rheumatrex, Otrexup, Rasuvo, Reditrex.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Inositol Nicotinate and Methotrexate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Inositol Nicotinate and Methotrexate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Methotrexate and Inositol Nicotinate in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Inositol Nicotinate safety at a glance

Inositol Nicotinat... overall Use caution Generally tolerated short-term but evidence is limited and high-dose niacin compounds can affect the liver.
Pregnancy Avoid Not enough safety data; avoid unless directed by your doctor.
Breastfeeding Avoid Safety has not been established; best to avoid.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Methotrexate and Inositol Nicotinate? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Methotrexate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Methotrexate is filed under 6 classifications — including organic anion-transporting polypeptide substrates (oatp), organic anion transporter 3 (oat3) substrates, hepatotoxic drugs. Inositol Nicotinate has documented interactions with 4 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), antidiabetes drugs (moderate) and hmg-coa reductase inhibitors ("statins") (moderate) — and none of Methotrexate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Inositol Nicotinate Does Interact With Other Medications

Inositol Nicotinate has 223 moderate known drug interactions in our database — Methotrexate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 223 No known interaction 2,607 (incl. Methotrexate)
Taking anything else?

Check Another of Your Medications Against Inositol Nicotinate

Covers the 2,830 medications we’ve checked against Inositol Nicotinate. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Inositol Nicotinate and Methotrexate May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Liver problems Worth acting on Additional detail

    Inositol Nicotinate

    “Orally, inositol nicotinate is converted to niacin and is therefore likely to cause similar side effects as niacin. Niacin is associated with elevated liver function tests and jaundice, especially with doses of 3 grams daily or more, and when doses are rapidly increased. Because inositol nicotinate is converted to niacin, it may also cause hepatotoxicity”

    Inositol Nicotinate · Natural Medicines adverse-effect record, reported in neonatal jaundice.

    5 sources cited
    1. 496. Anon. Inositol hexaniacinate. Altern Med Rev 1998;3:222-3.
    2. 4458. Knodel LC, Talbert RL. Adverse effects of hypolipidaemic drugs. Med Toxicol 1987;2:10-32. PubMed
    3. 4863. American Society of Health-System Pharmacists. ASHP Therapeutic Position Statement on the safe use of niacin in the management of dyslipidemias. Am J Health Syst Pharm 1997;54:2815-9. DOI
    4. 6243. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
    5. 11690. Figge HL, Figge J, Souney PF, et al. Nicotinic acid: a review of its clinical use in the treatment of lipid disorders. Pharmacotherapy 1988;8:287-94. PubMed

    Methotrexate

    Listed in the ADVERSE REACTIONS section of the FDA label for Methotrexate. Read the label on DailyMed ›

  • Itching Additional detail

    Inositol Nicotinate

    “Orally, inositol nicotinate is converted to niacin and is therefore likely to cause similar side effects as niacin, including pruritus.”

    Inositol Nicotinate · Natural Medicines adverse-effect record, reported in pruritus.

    1 source cited
    1. 496. Anon. Inositol hexaniacinate. Altern Med Rev 1998;3:222-3.

    Methotrexate

    Listed in the ADVERSE REACTIONS section of the FDA label for Methotrexate. Read the label on DailyMed ›

  • Stomach pain Additional detail

    Inositol Nicotinate

    “Orally, inositol nicotinate is generally well tolerated.

    Most Common Adverse Effects:

    Orally: Abdominal pain, constipation, diarrhea, flushing, heartburn, liver enzyme elevation, nausea, vomiting.”

    Inositol Nicotinate · Natural Medicines adverse-effect record, reported in constipation.

    Methotrexate

    Listed in the ADVERSE REACTIONS section of the FDA label for Methotrexate. Read the label on DailyMed ›

  • Nausea / Diarrhea / Vomiting reported in 5.9% of FDA reports for Methotrexate Additional detail

    Inositol Nicotinate

    “Orally, inositol nicotinate is converted to niacin and is therefore likely to cause similar side effects as niacin, including gastrointestinal complaints such as nausea, vomiting, bloating, heartburn, diarrhea, and constipation. These adverse effects from niacin may be reduced by taking it with meals or antacids, and usually disappear within two weeks of continued therapy.”

    Inositol Nicotinate · Natural Medicines adverse-effect record, reported in constipation.

    4 sources cited
    1. 496. Anon. Inositol hexaniacinate. Altern Med Rev 1998;3:222-3.
    2. 4851. Gibbons LW, Gonzalez V, Gordon N, Grundy S. The prevalence of side effects with regular and sustained-release nicotinic acid. Am J Med 1995;99:378-85. PubMed
    3. 11690. Figge HL, Figge J, Souney PF, et al. Nicotinic acid: a review of its clinical use in the treatment of lipid disorders. Pharmacotherapy 1988;8:287-94. PubMed
    4. 26094. Brown WV. Niacin for lipid disorders. Indications, effectiveness, and safety. Postgrad Med. 1995 Aug;98(2):185-9, 192-3. PubMed

    Methotrexate

    Listed in the ADVERSE REACTIONS section of the FDA label for Methotrexate, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for Inositol Nicotinate but not commonly for Methotrexate: constipation, heartburn, bloating or gas and flushing.

Effects for Methotrexate come from the ADVERSE REACTIONS section of its FDA label; effects for Inositol Nicotinate come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 489,806 voluntary FDA FAERS reports for Methotrexate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Overlapping uses

What Methotrexate Is Prescribed For, and What Inositol Nicotinate Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Methotrexate is a prescription medicine with approved uses on its FDA label. Inositol Nicotinate is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Methotrexate is prescribed for: Methotrexate treats a wide range of serious conditions. In cancer care, it is used for acute lymphoblastic leukemia, non-Hodgkin lymphoma, osteosarcoma, breast cancer, head and neck cancer, and gestational trophoblastic neoplasia (a rare tumor related to pregnancy). It is also used to prevent and treat meningeal leukemia (cancer affecting the lining of the brain and spinal cord). Outside of cancer, methotrexate is prescribed for adults with rheumatoid arthritis (RA), children with polyarticular juvenile idiopathic arthritis (a form of childhood arthritis), and adults with severe psoriasis that hasn't responded well to other treatments.

Inositol Nicotinate has been studied for:

  • Psoriasis studied, not established Inositol Nicotinate has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Inositol Nicotinate for psoriasis

    Although there has been interest in using oral inositol nicotinate for psoriasis, there is insufficient reliable information about the clinical effects of inositol nicotinate for this purpose.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Methotrexate on your own; if you are taking Inositol Nicotinate for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Inositol Nicotinate or Methotrexate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Inositol Nicotinate or Methotrexate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Methotrexate

This page covers Inositol Nicotinate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methotrexate page lists 82 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Beer (major), Grapefruit (major) and Siberian Cocklebur (major).

By severity: 7 major · 60 moderate · 15 minor.

From our pharmacist’s overview on the Methotrexate page

“The liver is where methotrexate and supplements clash most. Methotrexate (Rheumatrex, Otrexup, Rasuvo), used for rheumatoid arthritis, psoriasis, and certain cancers, can strain the liver on its own, and 38 of the 82 interacting ingredients on this list add liver risk of their own, alcohol included, which makes this a list to approach…”

Reviewed by 2 · Jul 18, 2026

Open the Methotrexate interaction page

One more smart check

Taking Inositol Nicotinate as Part of a Dietary Supplement Product? Check It for Interactions

We hold 202 real supplement products containing Inositol Nicotinate, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Inositol Nicotinate. Even though Inositol Nicotinate itself has no known interaction with Methotrexate, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Inositol Nicotinate and Methotrexate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Inositol Nicotinate
Top 25%

#284 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Methotrexate
Top 5%

#49 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Inositol Nicotinate reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Inositol Nicotinate and Methotrexate records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Inositol Nicotinate

What is Inositol Nicotinate?

Inositol Nicotinate
  • Cholesterol support
  • Improving circulation
  • Raynaud's phenomenon
  • Intermittent claudication (leg pain with walking)
  • A 'no-flush' niacin alternative

Inositol nicotinate is a 'no-flush' form of niacin marketed for cholesterol and circulation. Evidence that it works as well as regular niacin is weak and inconsistent, and it is not a proven replacement for prescription cholesterol treatment. Talk to your pharmacist or doctor before using it, especially if you have liver problems or take other medicines.

Synthetic compound (inositol bound to niacin/nicotinic acid) · Tablets, capsules

An interaction check asks whether these two react with each other — it does not ask whether Inositol Nicotinate is a good idea for someone in your situation. Here is what our Inositol Nicotinate record says about it on its own.

Inositol Nicotinate: dosing

There is no well-established standard dose for inositol nicotinate, and products vary widely. Do not assume a higher dose is safer or more effective.

From our Inositol Nicotinate monograph — the full record covers uses, side effects and every documented interaction.

Read the full Inositol Nicotinate monograph & all interactions
Medication

About Methotrexate

What Is Methotrexate Used For?

Brand names: Rheumatrex, Otrexup, Rasuvo, Reditrex

Methotrexate treats a wide range of serious conditions. In cancer care, it is used for acute lymphoblastic leukemia, non-Hodgkin lymphoma, osteosarcoma, breast cancer, head and neck cancer, and gestational trophoblastic neoplasia (a rare tumor related to pregnancy). It is also used to prevent and treat meningeal leukemia (cancer affecting the lining of the brain and spinal cord).

Outside of cancer, methotrexate is prescribed for adults with rheumatoid arthritis (RA), children with polyarticular juvenile idiopathic arthritis (a form of childhood arthritis), and adults with severe psoriasis that hasn't responded well to other treatments.

Most-Reported Side Effects for Methotrexate

From FAERS, the FDA’s public side-effect reporting system (489,806 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Rheumatoid arthritis 42,798 reports
Arthralgia 40,830 reports
Fatigue 33,049 reports
Nausea 28,999 reports
Joint swelling 25,026 reports
See full Methotrexate drug information
Keep checking

Other Drugs & Inositol Nicotinate

Browse every other medication we’ve checked against Inositol Nicotinate — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
223Moderate
0Minor
2,606No known interaction
223 Moderate 2,606 No interaction
Moderate

223 interactions

Showing 60 of 223 moderate interactions — see all 223 on the Inositol Nicotinate page.

No interaction 2,606 drugs checked — show the list

We also checked Inositol Nicotinate against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,606 medications checked with no known interaction — see the full Inositol Nicotinate list.

See the full Inositol Nicotinate interactions page
See every supplement checked against Methotrexate, ranked by severity
Evidence & sources

Inositol Nicotinate References

The 21 references that drive our Inositol Nicotinate monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Anon. Inositol hexaniacinate. Altern Med Rev 1998;3:222-3.
  2. Holti G. An experimentally controlled evaluation of the effect of inositol nicotinate upon the digital blood flow in patients with Raynaud's phenomenon. J Int Med Res 1979;7:473-83. PubMed
  3. Knodel LC, Talbert RL. Adverse effects of hypolipidaemic drugs. Med Toxicol 1987;2:10-32. PubMed
  4. Gibbons LW, Gonzalez V, Gordon N, Grundy S. The prevalence of side effects with regular and sustained-release nicotinic acid. Am J Med 1995;99:378-85. PubMed
  5. Crouse JR III. New developments in the use of niacin for treatment of hyperlipidemia: new considerations in the use of an old drug. Coron Artery Dis 1996;7:321-6. PubMed
  6. Garg A, Grundy SM. Nicotinic acid as therapy for dyslipidemia in non-insulin-dependent diabetes mellitus. JAMA 1990;264:723-6. DOI
  7. American Society of Health-System Pharmacists. ASHP Therapeutic Position Statement on the safe use of niacin in the management of dyslipidemias. Am J Health Syst Pharm 1997;54:2815-9. DOI
  8. Guyton JR, Goldberg AC, Kreisberg RA, et al. Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia. Am J Cardiol 1998;82:737-43.
  9. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
  10. Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
  11. Bays HE, Dujovne CA. Drug interactions of lipid-altering drugs. Drug Saf 1998;19:355-71. PubMed
  12. Figge HL, Figge J, Souney PF, et al. Nicotinic acid: a review of its clinical use in the treatment of lipid disorders. Pharmacotherapy 1988;8:287-94. PubMed
  13. McKenney J. New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med 2004;164:697-705. PubMed
  14. Reaven P, Witztum JL. Lovastatin, nicotinic acid and rhabdomyolysis (letter). Ann Int Med 1988;109:597-8. PubMed
  15. Ito MK. Advances in the understanding and management of dyslipidemia: using niacin-based therapies. Am J Health-Syst Pharm 2003;60(suppl 2):s15-21. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Inositol Nicotinate and Methotrexate Together: Common Questions

Is it safe to take Inositol Nicotinate with Methotrexate?
We do not list a known interaction between Inositol Nicotinate and Methotrexate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Inositol Nicotinate and Methotrexate have any of the same side effects?
Yes — our sources link each of them separately to 6 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Inositol Nicotinate and Methotrexate used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Inositol Nicotinate in each. That is a conversation for your prescriber, especially if Methotrexate is being adjusted to a target.
How was the Inositol Nicotinate and Methotrexate combination checked?
Interactions in our licensed database are recorded against drug classes. Methotrexate is filed under 6 classifications, and Inositol Nicotinate has documented interactions with 4 drug classes — none of Methotrexate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Inositol Nicotinate interact with any other medications?
Yes. Inositol Nicotinate has 223 documented drug interactions in our database — Methotrexate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Methotrexate interact with any supplements?
Yes. Methotrexate has documented interactions with 82 supplements in our database — Inositol Nicotinate is not one of them. The Methotrexate interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Inositol Nicotinate monograph Uses, safety profile, and every drug interaction in one place Methotrexate drug information The full plain-English guide to this medication Methotrexate supplement interactions Every supplement checked against Methotrexate, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 21 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Methotrexate and Inositol Nicotinate?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.