( An ISO 9001:2015 Certified International Journal )

An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)

European Journal of Pharmaceutical and Medical Research (EJPMR) has indexed with various reputed international bodies like : Google Scholar , Indian Science Publications , InfoBase Index (In Process) , SOCOLAR, China , Research Bible, Fuchu, Tokyo. JAPAN , International Society for Research activity (ISRA) , Scientific Indexing Services (SIS) , Polish Scholarly Bibliography , Global Impact Factor (GIF) (Under Process) , Universal Impact Factor , International Scientific Indexing (ISI), UAE  , Index Copernicus , CAS (A Division of American Chemical Society) USA (Under Process) , Directory of Open Access Journal (DOAJ, Sweden, in process) , UDLedge Science Citation Index , CiteFactor , Directory Of Research Journal Indexing (DRJI) , Indian citation Index (ICI) , Journal Index (JI, Under Process) , Directory of abstract indexing for Journals (DAIJ) , Open Access Journals (Under Process) , Impact Factor Services For International Journals (IFSIJ) , Cosmos Impact Factor , Jour Informatics (Under Process) , Eurasian Scientific Journal Index (ESJI) , International Innovative Journal Impact Factor (IIJIF) , Science Library Index, Dubai, United Arab Emirates , Pubmed Database [NLM ID: 101669306] (Under Process) , IP Indexing (IP Value 2.40) , Web of Science Group (Under Process) , Directory of Research Journals Indexing , Scholar Article Journal Index (SAJI) , International Scientific Indexing ( ISI ) , 

 ISSN 2394-3211

Impact Factor: 6.222

 ICV - 79.57



Zakaria El Ouali*, Kawtar Nassar and Saadia Janani


Background: In spite of its tolerance issues, methotrexate is still considered as the cornerstone among conventional disease-modifying antirheumatic drugs in rheumatoid arthritis. Some patients report a reduction of gastrointestinal side effects when they consume caffeine concomitantly. However, some studies suggest that caffeine can reduce the efficacy of methotrexate. Objective: To break through this paradox, the aim of this study was to evaluate the effects of caffeine consumption on efficacy and tolerance of methotrexate in patients with rheumatic diseases. Methods: A systematic review was performed following the PRISMA statement to identify all published clinical studies that evaluated the effect of caffeine on the efficacy and tolerance of methotrexate in patients with rheumatic diseases. PubMed, Google Scholar, ScienceDirect, and Cochrane Library databases were investigated from January 2000 until June 2020. Results: Among 34 identified studies, 7 fulfilled our criteria for inclusion: three studies were about efficacy, and four about tolerance. Taken together, these studies tend to show that caffeine consumption does not reduce the efficacy of methotrexate, and that caffeine consumption concomitantly with the weekly dose of treatment improves its tolerance. Conclusion: Available studies to date are limited but allow to draw clinical implications for the management of methotrexate intolerance. First, caffeine doesn’t seem not reduce the efficacy of methotrexate. Second, caffeine may improve methotrexate tolerance when taken concomitantly with the medication weekly dose. The addition of 2 cups of coffee in the morning of the medication day, and another 2 cups 1-3 hours before taking the MTX may help in alleviating symptoms.

Keywords: Caffeine; Methotrexate; Efficacy; Tolerance; Rheumatoid arthritis; Adenosine.

[Full Text Article]



  • New Issue Published

    Its Our pleasure to inform you that, EJPMR 1 September 2021 Issue has been Published, Kindly check it on


    SEPTEMBER Issue has been successfully launched on 1 September 2021.

  • EJPMR New Impact Factor

    Its our Pleasure to Inform you that EJPMR Impact Factor has been increased from  5.804 to 6.222, due to high quality Publication at International Level

  • Index Copernicus Value

    EJPMR Received Index Copernicus Value 79.57, due to High Quality Publication in EJPMR at International Level

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Google Scholar Indian Science Publications InfoBase Index (In Process) SOCOLAR, China Research Bible, Fuchu, Tokyo. JAPAN International Society for Research activity (ISRA) Scientific Indexing Services (SIS) Polish Scholarly Bibliography Global Impact Factor (GIF) (Under Process) Universal Impact Factor International Scientific Indexing (ISI), UAE Index Copernicus CAS (A Division of American Chemical Society) USA (Under Process) Directory of Open Access Journal (DOAJ, Sweden, in process) UDLedge Science Citation Index CiteFactor Directory Of Research Journal Indexing (DRJI) Indian citation Index (ICI) Journal Index (JI, Under Process) Directory of abstract indexing for Journals (DAIJ) Open Access Journals (Under Process) Impact Factor Services For International Journals (IFSIJ) Cosmos Impact Factor Jour Informatics (Under Process) Eurasian Scientific Journal Index (ESJI) International Innovative Journal Impact Factor (IIJIF) Science Library Index, Dubai, United Arab Emirates Pubmed Database [NLM ID: 101669306] (Under Process) IP Indexing (IP Value 2.40) Web of Science Group (Under Process) Directory of Research Journals Indexing Scholar Article Journal Index (SAJI) International Scientific Indexing ( ISI )