Cimzia vs. Methotrexate

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Reduces inflammation. Cimzia (Certolizumab) is an effective medicine to calm down your immune system, but it can be expensive and it requires a lot of monitoring while you're taking it.Treats cancer and changes how your immune system works. Otrexup (Methotrexate) is a first line treatment for many autoimmune diseases and types of cancer. If you're taking it for a long time, you'll have to get routine blood tests.
How it works
Cimzia (Certolizumab) is a monoclonal antibody. It lowers inflammation in the body by blocking a protein called TNF (tumor necrosis factor).Otrexup (Methotrexate) is an anti-cancer and immunosuppressive medication that treats forms of cancer, arthritis, and psoriasis. For cancer, it helps your body destroy cancer cells by blocking building blocks that cancer cells need to grow. For rheumatoid arthritis and psoriasis, it lowers the body's normal immune response and prevents the body from attacking itself.
Type of medication
Biological response modifier
Prescription only
Biological response modifier
Prescription only
Available as
  • Injection
  • Pill
  • Injection
Used for (click to learn more)
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Reviews & ratings
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Side effects
  • Upper respiratory infections 7%
  • Common cold 4%
  • Ear, nose, or throat infection 4%
  • High blood pressure 3%
  • Back pain 3%
  • Joint pain 2%
  • Acute bronchitis 2%
  • Rash 2%
  • Sore throat 2%
  • Urinary tract infections 1%
More Cimzia side effects »

The Methotrexate FDA package insert doesn’t have numbers about how common side effects are.

More about Methotrexate side effects »
Risk factors for serious side effects
  • Medications that lower immune system function
  • Younger age
      • History of heart failure
        Detailed Cimzia (Certolizumab) risks & warnings »
        • Women of childbearing age
        • Men of childbearing potential
          • Reduced kidney function
          • fluid in the abdomen (ascites)
          • fluid in the lungs (pleural effusion)
          • Long-term use
          • Psoriasis
            • Taking Otrexup (Methotrexate) with high-dose NSAIDs
              • Taking Otrexup (Methotrexate) to treat cancer
              • Rapidly growing tumors
              Detailed Otrexup (Methotrexate) risks & warnings »
              Pregnancy category
              BFDA pregnancy category (Probably safe)

              Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

              See the FDA package insert
              XFDA pregnancy category (Unsafe)

              Research studies with real people or animals found harmful effects on unborn babies. If you’re pregnant, the risks to your unborn baby outweigh the benefits.

              See the FDA package insert
              No specific alcohol-related info.
              • You have to avoid alcohol and being in the sun too long.
              • Don't use alcohol, NSAIDs (anti-inflammatory medications), or stay in the sun too long.
              No specific food-related info.No specific food-related info.
              Kidneys and liver
              No specific kidneys and liver-related info.
              • If you're taking Otrexup (Methotrexate), you’ll need to have your blood checked to avoid toxic effects (blood cells, platelets, liver enzymes, kidney function) and chest X-rays when you start and every 1 to 2 months during treatment. Otrexup (Methotrexate) can also cause malignant lymphoma (cancer of the white blood cells). It can happen when you take low-doses of Otrexup (Methotrexate).
              • You are at higher risk of having toxic symptoms because of too much Otrexup (Methotrexate) in your blood if you have kidney disease, or if you have fluid in the abdomen (ascites) or in the lungs (pleural effusion). Your doctor will monitor your body's reaction to Otrexup (Methotrexate) very closely if they decide you need to be on Otrexup (Methotrexate).
              • Tumor lysis syndrome happens when cancer cells are broken down very quickly and damage the kidneys. The damage can be so bad that people need dialysis. If you're taking Otrexup (Methotrexate) to treat cancer, your doctor can give you medicines and take measures to prevent this reaction.
              No specific sex-related info.No specific sex-related info.
              No specific sleep-related info.No specific sleep-related info.
              • Tell your doctor if you have night sweats, persistent fever, fatigue, weight loss, or swollen lymph nodes.
              • Cimzia (Certolizumab) can increase the risk of lymphoma, leukemia, and other cancers. Talk to your doctor if you have night sweats, persistent fever, fatigue, weight loss, or swollen lymph nodes.
              No specific weight-related info.
              Upsides and benefits
              • In studies, people with RA (rheumatoid arthritis) taking methotrexate had improved symptoms when Cimzia (Certolizumab) was added to methotrexate.
              • Cimzia (Certolizumab) is as effective as other similar medicines for Crohn's disease. It can be an option for people taking other RA medications that have too many side effects of don't work anymore.
              • Cimzia (Certolizumab) lasts longer in the body than other RA medications, letting it work longer.
              • Available in a prefilled syringe. This can make it easier to give yourself the injection.
              • Recommended as first line treatment for rheumatoid arthritis.
              • Available as a generic medication. Comes as a tablet, an injection that you give yourself weekly, and as an infusion that you get in your doctor's office or at an infusion center.
              • If you accidentally take too much, there's an antidote to help your body recover.
              Downsides and risks
              • Can lower your immune system's ability to fight infections. You can get serious infections such as TB (tuberculosis) and infections caused by viruses, fungi, or bacteria.
              • Can have a higher risk for causing bladder infections, rash, and upper respiratory infections (cold or flu) compared to other similar medicines.
              • Cimzia (Certolizumab) can increase the risk of lymphoma, leukemia, and other cancers.
              • Requires routine tests to check for infections.
              • Not a good choice if you have a history of heart failure, nervous system problems, or hepatitis B.
              • There's no generic available and it can be very expensive.
              • You have to be on birth control for at least 2 to 3 months after you finish Otrexup (Methotrexate) since it can cause birth defects.
              • You have to avoid alcohol and being in the sun too long.
              • You'll have to get blood tests done if you're taking this long-term because it can cause harmful side effects.
              Tips from our pharmacists for people taking the medication
              • Cimzia (Certolizumab) is a medicine that's injected just under the skin (subcutaneous). It can be given in your doctor's office or you can do it yourself at home.
              • It can take multiple doses before you start to see any effects, so don't change your dose without talking to your doctor.
              • Tell your doctor if you have night sweats, persistent fever, fatigue, weight loss, or swollen lymph nodes.
              • You'll need to have a TB (tuberculosis) test before you start Cimzia (Certolizumab) and periodically during treatment.
              • Don't get any live vaccines while you're taking Cimzia (Certolizumab) since they may not work as well. Wait at least 3 months after you've stopped taking Cimzia (Certolizumab) before getting a live vaccine.
              • Don't use alcohol, NSAIDs (anti-inflammatory medications), or stay in the sun too long.
              • Use birth control and avoid pregnancy for at least 2 months (for women) and 3 months (for men) after you finish Otrexup (Methotrexate).
              • Drink plenty of liquids to stay hydrated while taking this.
              • Take the medication exactly as your doctor or pharmacist tells you. Call your doctor or pharmacist if you're confused.
              Learn more
              More about CimziaSide effectsReviews & ratingsAlternativesFDA package insert
              More about MethotrexateSide effectsReviews & ratingsAlternativesFDA package insert