The Canadian Rheumatology Association has released an update concerning the recent advisory from Health Canada on the concomitant use of Methotrexate and PPIs. An amended release has been made suggesting that the alert pertains more to high dose chemotherapy doses of Methotrexate and not to doses used in inflammatory disease.  The ORA applauds the quick and effective response from the CRA on an issue that will generate a lot of questions from local pharmacists and patients.