Remicade vs. Methotrexate

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Calms down your immune system. Remicade (Infliximab) is very effective at calming down your immune system, but you have to get each dose at your doctor's office and watch out for 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.
How it works
Remicade (Infliximab) is a biologic response modifier. It works in the immune system to block a protein called TNF (tumor necrosis factor). Blocking TNF relieves symptoms and prevents disease progression.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
Button Group. All currently active
Button Group. All currently active
Reviews for Remicade (Infliximab)
of people say Remicade (Infliximab) is worth it
say it works well
say it's a big hassle
Side effects
  • Infusion reaction 13%
  • Infections 11%
More Remicade 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
    • History of heart failure
    • Taking other immunosuppressant drugs
    • Age 60 or older
    • Taking other immunosuppressant drugs
    • History of malignancy
    • History of neurologic condition
        Detailed Remicade (Infliximab) 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.
              • Remicade (Infliximab) can increase your risk of serious or life-threatening bacterial, fungal and viral infections. 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 Remicade (Infliximab). 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.
              • Although rare, Remicade (Infliximab) can cause serious liver injury. You'll need to have your liver enzymes tested regularly. If liver enzymes are significantly elevated and you have appetite/weight loss, stomach discomfort, vomiting, and notice dark urine, yellowing of skin/eyes, change in stool color, and skin rash you should stop treatment with Remicade (Infliximab) until you can be completely assessed,
              No specific weight-related info.
              Upsides and benefits
              • Treats certain types of arthritis and gastrointestinal conditions caused by an overactive immune system.
              • Remicade has almost two decades of clinical trial data and real-life experience with millions of people who have used it.
              • Initial dosing to introduce Remicade to your body might be a hassle, but then you only need to take it every 6-8 weeks depending on your condition.
              • 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 have to get every dose through an IV infusion at your doctor's office.
              • It's expensive because there's no generic available yet.
              • Remicade has a higher risk of serious infusion-related side effects during or after it's given since it's injected right into your veins. Your doctor can prescribe medication before your dose that may lower this risk.
              • Remicade lowers your ability to fight infection and can cause serious life-threatening illness. The risk is greater if you take other drugs that lower your immune system, have an active infection, diabetes, or had tuberculosis (TB) in the past.
              • Not the best choice if you have heart failure.
              • Talk to your baby's doctor if you're pregnant or breast-feeding. When women in a study took Remicade (Infliximab), the medicine was found in their breast milk 2 to 3 days after each dose, and in the baby's blood 6 months after they were born.
              • 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
              • Remicade (Infliximab) is a medication that's given as an infusion at your doctor's office or clinic.
              • It's very important to read the patient Medication Guide when you first start using Remicade (Infliximab).
              • It's possible to get an allergic reaction to Remicade (Infliximab) either immediately during the treatment or a several days after stopping it. Your doctor can give you medicines that'll lower this risk.
              • You'll need to have a TB test before you start taking Remicade (Infliximab) and periodically during treatment.
              • Remicade (Infliximab) lowers your immune system's ability to fight infections, so it's important to let your doctor know if you notice a fever, cough, or flu-like symptoms. Children seem to get more infections than adults, so keep a close eye on them.
              • If you have a young child, let their doctor know if you were on Remicade (Infliximab) while pregnant or nursing. It can increase their risk of infections for several months after your last dose and can delay their vaccine schedule.
              • 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 RemicadeSide effectsReviews & ratingsAlternativesFDA package insert
              More about MethotrexateSide effectsReviews & ratingsAlternativesFDA package insert