Compare Orencia vs. methotrexate

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

Orencia (abatacept)

Prescription only

Otrexup (methotrexate)

Prescription only
Calms down the immune system and prevents joint damage.

Orencia (abatacept) slows the progress of rheumatoid arthritis, but can also cause serious side effects.

Reduces inflammation and cell replication.

Otrexup (methotrexate) is the first-choice treatment for many types of cancer and arthritis, but it has many side effects.

Upsides
  • In a 2-year study that used IV Orencia (abatacept) with methotrexate, more than half of the people had remission and the majority felt significantly better.
  • Helps minimize joint damage, lowers symptoms, and prevents future problems. People taking Orencia (abatacept) had no new joint damage after two years.
  • Taking Orencia (abatacept) allows RA patients to use less prednisone, a steroid that has many side effects.
  • You can give yourself Orencia (abatacept) subcutaneously on your own at home rather than visiting a clinic or hospital.
  • Available in a prefilled autoinjector for convenient use.
  • Otrexup (methotrexate) is available as an affordable generic form.
  • Otrexup (methotrexate) comes as a tablet, an injection that you give yourself, or an infusion that you get in the doctor's office or infusion center.
Downsides
  • Orencia (abatacept) can be costly.
  • The IV infusion form of Orencia (abatacept) can cause a reaction, which ranges from a slight itching or warm feeling to more serious side effects such as low blood pressure and chest pain.
  • The IV infusion form of Orencia (abatacept) contains maltose, a type of sugar, that can give false high blood sugar readings with certain types of blood sugar monitors on the day of Orencia (abatacept) infusion. The self-injection subcutaneous form does not contain maltose. Talk to your doctor if you have diabetes.
  • If you need TNF inhibitors as part of your treatment, it is not recommended to take Orencia (abatacept). If you have COPD, you are at higher risk of side effects.
  • Orencia (abatacept) lowers your ability to fight infection. Your risk can increase if you take medications that lower your immune system or have an active infection. You may need to get tested for tuberculosis before starting Orencia (abatacept).
  • You may need frequent blood tests for monitoring when taking Otrexup (methotrexate).
  • Otrexup (methotrexate) can cause serious birth defects so women should avoid getting pregnant for at least 6 month and men 3 months after taking it.
  • While on Otrexup (methotrexate), you should avoid alcohol and staying out in the sun for too long.
Used for
Dosage forms
  • Infusion
  • Injection
  • Pill
  • Injection
  • Liquid
Price
Want to save even more money?
Sign up now for a 30-day trial and save up to 95% at CVS, Kroger, Albertsons, and other pharmacies.
Reviews
Not enough review data.Leave a review
Not enough review data.Leave a review
Side effects
10possible side effects
  • Headache
    18%
  • Common cold
    12%
  • Dizziness
    9%
  • Cough
    8%
  • Back pain
    7%
  • High blood pressure
    7%
  • Indigestion
    6%
  • Urinary tract infection
    6%
  • Rash
    4%
  • Pain in arms or legs
    3%
See more detailed side effects
The Otrexup (methotrexate) FDA package insert doesn’t have numbers about how common side effects are.
Risks and risk factors
  • High risk of infections with TNF inhibitors
    • Using TNF inhibitors
  • Severe allergic reactions
  • Lower effectiveness of vaccines
  • Immunosuppression and Infections
    • Taking immunosuppressive medications
    • History of repeat infections
    • Adults with rheumatoid arthritis taking TNF inhibitors
  • More COPD side effects
    • COPD
See more detailed risks and warnings
  • Bone marrow suppression
  • Worsening side-effects
    • Reduced kidney function
    • fluid in the abdomen
    • fluid in the lungs
  • Use of NSAIDs
    • NSAIDS
    • High dose of methotrexate
  • Liver problems
    • Long-term use
    • Psoriasis
  • Lung problems
  • Diarrhea and mouth sores
    • Taking Otrexup (methotrexate) with high-dose NSAIDs
  • Tumor lysis syndrome
    • Rapidly growing tumors
  • Skin reactions
  • Infections
  • White blood cell cancer
  • Skin and bone tissue deterioration
    • Radiotherapy
See more detailed risks and warnings