Interactions with methotrexate.
NAD+ (nicotinamide adenine dinucleotide) is touted as an anti-ageing miracle pill, but there is scant evidence to support such a claim. I have looked in the literature and, so far as I am aware, there is not likely to be any significant interaction with methotrexate.
Pterostilbene is marginally more interesting, because it is chemically very similar to resveratrol, which is an active ingredient of red wine. You will recall a load of hype about the benefits of red wine about 15-years ago and some enterprising people even put resveratrol into a pill. Both pterostilbene and resveratrol are said to have antioxidant, anti-inflammatory, anti-carcinogenic and anti-ageing properties. However, as is often the case, the scientific evidence actually eclipsed the hype; neither molecule could be shown to do what was claimed. In fact, some recent studies suggest they may even increase oxidative stress in cells.
What about their interaction with methotrexate? I found one interesting study in rats, which suggests that resveratrol may protect against hepatic injury, which is a well-known potential side-effect of methotrexate. Whether this benefit occurs in humans is unknown and, as I say, this study was on resveratrol, rather than pterostilbene. There are no other relevant studies that I can find.
Summary
In summary, I can find no evidence that either NAD+ or Pterostilbene have any significant interactions with methotrexate.
