Compare Orencia vs. Methotrexate

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



Orencia (Abatacept) decreases inflammation in rheumatoid arthritis. Orencia (Abatacept) slows the progress of rheumatoid arthritis, but can also have serious side effects.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.
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  • Coupons for Orencia (Abatacept)
  • Cost for (1) 4 syringes of 125mg/ml carton of Orencia (Abatacept)
Reviews & ratings
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Side effects
  • Headache 5%
  • High blood pressure 3%
  • Common cold 3%
  • Indigestion 2%
  • Dizziness 2%
  • Back pain 1%
  • Rash 1%
  • Pain in extremity 1%
  • Cough 1%
  • Urinary tract infection 1%
More Orencia side effects »

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

More about Methotrexate side effects »
How it works
Orencia (Abatacept) is called a DMARD, a disease-modifying antirheumatic drug. It prevents your body from activating cells that cause inflammation.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)
Risk factors for serious side effects
        • Taking immunosuppressive medications
        • History of repeat infections
        • Adults with rheumatoid arthritis taking TNF inhibitors
        Detailed Orencia (Abatacept) 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
              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
              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.
              No specific weight-related info.No specific weight-related info.
              Upsides and benefits
              • Helps minimize joint damage, lowers symptoms, and prevents future problems.
              • 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.
              • People taking [name-common] 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.
              • Orencia (Abatacept) can be used without other medications for RA.
              • 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
              • You'll have to get your blood tested regularly while taking Orencia (Abatacept).
              • You'll probably have to take other medications to help treat your RA symptoms.
              • Orencia (Abatacept) is pretty expensive.
              • The IV infusion form of Orencia (Abatacept) can cause a reaction, which ranges from a slight itching or warm feeling to more serious complications like low blood pressure and chest pain.
              • Because RA is chronic disease, you'll likely take Orencia (Abatacept) for many years.
              • 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
              • Keep the Orencia (Abatacept) self-injection refrigerated, but let it rest at room temperature for 30 to 60 minutes before using it.
              • Each time you use Orencia (Abatacept), be sure to rotate the sites you chose to inject it in. Don't inject it where your skin is tender, bruised, red, or scaly.
              • If you decide to go with the IV version of Orencia (Abatacept), you will only need to get infusions once a month. The self-injections however need to be taken once a week.
              • If you get the IV infusion, stay hydrated, try to relax, and ask your nurse to apply dry heat (instant warm packs) to your arm to help find your good veins.
              • 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 OrenciaSide effectsReviews & ratingsAlternativesFDA package insert
              More about MethotrexateSide effectsReviews & ratingsAlternativesFDA package insert