Compare Methotrexate vs. Rituxan

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Otrexup
(Methotrexate)

Rituxan
(Rituximab)

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.Calms down your immune system. Rituxan (Rituximab) is effective for treating multiple types of cancer and arthritis. That said, you'll need to watch for possibly serious side effects, especially infusion reactions.
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Side effects
MethotrexateRituxan

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

More about Methotrexate side effects »
  • Low blood phosphate 11%
  • Acute infusion reactions 8%
  • Cardiac side effect 1%
More Rituxan side effects »
How it works
MethotrexateRituxan
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.Rituxan (Rituximab) is a monoclonal antibody. It targets a specific protein on white blood cells that makes it easier for your immune system to find and destroy cancerous cells. It also relieves symptoms and slows the progression of Rheumatoid Arthritis.
Type of medication
MethotrexateRituxan
Immunosuppressant
Immunomodulator
Antirheumatic
Biological response modifier
Anticancer
Antimetabolite
Prescription only
Immunosuppressant
Immunomodulator
Antirheumatic
Biological response modifier
Anticancer
Biological response modifier
Prescription only
Available as
MethotrexateRituxan
  • Pill
  • Injection
  • Infusion (IV)
Used for (click to learn more)
MethotrexateRituxan
Risk factors for serious side effects
MethotrexateRituxan
  • 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 »
          • Taking other immunosuppressant drugs
          • Age 60 or older
          • Weak immune system
          • Taking Rituxan (Rituximab) with immunosuppressant drugs (if using for RA)
          • Taking Rituxan (Rituximab) with chemotherapy (if using for NHL or CLL
          • Stem cell transplant
            • Taking Rituxan (Rituximab) for Non-Hodgkin's Lymphoma (NHL)
            • Rapidly growing tumors
            • History of heart problems
            • Drug interactions
            • Start of therapy with Rituxan (Rituximab)
              Detailed Rituxan (Rituximab) risks & warnings »
              Pregnancy category
              MethotrexateRituxan
              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
              CFDA pregnancy category (Weigh risks vs. benefits)

              Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

              See the FDA package insert
              Alcohol
              • 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 alcohol-related info.
              Food
              No specific food-related info.No specific food-related info.
              Kidneys and liver
              • 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.
              • Discuss with your doctor the serious heart, kidney, liver, or stomach problems that can happen while on Rituxan (Rituximab).
              • Tumor lysis syndrome (TLS) 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 Rituxan (Rituximab) for a cancer condition your doctor can give you medicines and take measures to prevent this reaction.
              Sex
              No specific sex-related info.No specific sex-related info.
              Sleep
              No specific sleep-related info.No specific sleep-related info.
              Weight
              No specific weight-related info.
              • Rituxan (Rituximab) can increase your risk of serious or life-threatening bacterial, fungal and viral infections including sepsis. In some cases infections can be reactivated from an inactive virus in your body like tuberculosis (TB) or hepatitis B virus (HBV). You may need to take medicine for TB before you can begin taking Rituxan (Rituximab). If you develop symptoms of cough, fever, chills, muscle aches, feel very tired, or you notice dark urine, yellowing of skin/eyes, appetite/weight loss, vomiting, change in stool color, stomach discomfort, and skin rash, tell your doctor and get medical care right away.
              Upsides and benefits
              MethotrexateRituxan
              • 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.
              • Treats leukemia, lymphoma, and blood vessel inflammation.
              • Also treats moderate to severe rheumatoid arthritis that hasn't responded to anti-TNF treatment (but you'll need to take methotrexate too).
              • The chance of having a reaction to the infusion is highest during your first dose, but the risk decreases each time you get Rituxan (Rituximab). It usually happens within 30 minutes to 2 hours after starting the infusion.
              • Rituxan (Rituximab) is a targeted therapy that works differently than chemotherapy. Both work well when they're taken together, especially when treating CLL and NHL.
              Downsides and risks
              MethotrexateRituxan
              • 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.
              • Only your doctor or other trained medical staff can administer Rituxan (Rituximab), so you'll need to go into an office or clinic for every dose.
              • Not the best choice if you have heart problems.
              • Rituxan (Rituximab) can stay in your body for up to 6 months after you complete treatment. Men and women who are able to have children need to use birth control for up to one year after finishing Rituxan (Rituximab).
              • Discuss with your doctor the serious heart, kidney, liver, or stomach problems that can happen while on Rituxan (Rituximab).
              Tips from our pharmacists for people taking the medication
              MethotrexateRituxan
              • 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.
              • Rituxan (Rituximab) is given as an IV infusion by trained medical staff in a clinic or hospital.
              • You'll need to be monitored in the clinic in case you have a serious or life-threatening reaction during the infusion, but you can take other medications that'll lower your risk of this happening.
              • It's very important that you read the Medication Guide before you start taking Rituxan (Rituximab).
              • Rituxan (Rituximab) lowers your immune system's ability to fight infections, so it's important to let your doctor know if you notice a fever, a cough that doesn't go away, or flu-like symptoms.
              • Use effective birth control while you're taking Rituxan (Rituximab) and for 12 months after you finish treatment.
              • Don't get live vaccines while you're taking Rituxan (Rituximab).
              Learn more
              More about MethotrexateSide effectsReviews & ratingsAlternativesFDA package insert
              More about RituxanSide effectsReviews & ratingsAlternativesFDA package insert