Prescription onlyLower-cost generic availableClass: Autoimmune

Otrexup Alternatives

(methotrexate)

Prescription onlyLower-cost generic availableClass: Autoimmune
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Compare Otrexup (methotrexate) to alternatives

These medications are comparable to Otrexup (methotrexate) or used for similar purposes.

Otrexup
(methotrexate)

Enbrel
(etanercept)

Neoral
(cyclosporine)

Humira
(adalimumab)

Remicade
(infliximab)

Stelara
(ustekinumab)

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 to prevent joint damage. Enbrel (etanercept) effectively calms down your immune system, but it puts you at risk of serious infections.Coming soon.Calms down the immune system. Humira (adalimumab) is good for treating many autoimmune conditions, but it can also cause serious side effects.Calms down your immune system. Remicade (infliximab) is an effective treatment for many autoimmune diseases, but you can have serious side effects.Treats moderate to severe psoriasis. Stelara (Ustekinumab) works for two psoriatic conditions. It may be somewhat of a hassle because of the injection, but after the first two doses, you only need to take it every 12 weeks.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected

Not enough reviews for this treatment. Help someone out, leave a review!

Have you used Otrexup (methotrexate)?
Worth itNot sureNot worth it
Reviews for Enbrel
62%
+13% better vs. Methotrexate
53%
-3% worse vs. Methotrexate
17%
+17% better vs. Methotrexate
Have you used Enbrel (etanercept)?
Worth itNot sureNot worth it

Not enough reviews for this treatment. Help someone out, leave a review!

Have you used Neoral (cyclosporine)?
Worth itNot sureNot worth it
Reviews for Humira
60%
+15% better vs. Methotrexate
51%
-1% worse vs. Methotrexate
26%
+26% better vs. Methotrexate
182 reviews
Have you used Humira (adalimumab)?
Worth itNot sureNot worth it
Reviews for Remicade
76%
-1% worse vs. Methotrexate
62%
-12% worse vs. Methotrexate
15%
+15% better vs. Methotrexate
Have you used Remicade (infliximab)?
Worth itNot sureNot worth it
Reviews for Stelara
48%
+27% better vs. Methotrexate
42%
+8% better vs. Methotrexate
20%
+20% better vs. Methotrexate
Have you used Stelara (ustekinumab)?
Worth itNot sureNot worth it
Side effects
MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
  • Elevated liver function tests 15%
  • Nausea/vomiting 10%
  • Stomatitis 10%
  • Thrombocytopenia 10%
  • Rash/pruritus/dermatitis 3%
  • Diarrhea 3%
  • Alopecia 3%
  • Leukopenia 3%
  • Pancytopenia 3%
  • Dizziness 3%
More Methotrexate side effects »
  • Infections 11%
  • Upper airway infections 8%
  • Injection site reactions 26%
  • Non-upper respiratory infections 6%
  • Rash 1%
  • Fever 3%
  • Itchiness 1%
More Enbrel side effects »

We haven’t found good data for Cyclosporine side effects.

FDA side effect reports for Cyclosporine »
  • Upper airway infection 4%
  • Rash 6%
  • Headache 4%
  • Sinus infection 2%
  • Nausea 1%
  • Injection site reactions 7%
  • Urinary tract infection 3%
  • Flu syndrome 1%
  • Stomach pain 3%
  • High cholesterol 2%
More Humira side effects »
  • Upper airway infection 7%
  • Nausea 1%
  • Headache 4%
  • Sinus infection 6%
  • Sore throat 4%
  • Coughinng 4%
  • Abdominal pain 4%
  • Bronchitis 1%
  • Rash 5%
More Remicade side effects »
  • Headache 2%
  • Fatigue 1%
  • Pruritus 1%
  • Back pain 1%
  • Dizziness 1%
  • Pharyngolaryngeal pain 1%
  • Injection site erythema 2%
More Stelara side effects »
How it works
MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
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.Enbrel (etanercept) blocks a protein called TNF (tumor necrosis factor) in the immune system which lowers inflammation, relieves symptoms and prevents disease progression.Coming soon.Humira (adalimumab) is a TNF blocker which stops inflammation.Remicade (infliximab) blocks a protein in your immune system called TNF (tumor necrosis factor) that causes inflammation.Stelara (Ustekinumab) is a biologic response modifier, or biologic. It blocks two immune system proteins called IL-12 and IL-23. This slows down new skin cell formation, and lowers inflammation for people with psoriasis or psoriatic arthritis.
Type of medication
MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
Prescription onlyPrescription onlyPrescription onlyPrescription onlyPrescription only
Available as
MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
  • Pill
  • Injection
  • Injection
  • Pill
  • Liquid
  • Injection
  • Injection
  • Injection
Used for
MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
  • Cardiac Transplant Rejection Prophylaxis Liver Transplant Rejection Prophylaxis Plaque Psoriasis Severe
Risk factors for serious side effects
MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
  • Women of childbearing age
  • Men of childbearing potential
  • Reduced kidney function
  • fluid in the abdomen (ascites)
  • fluid in the lungs (pleural effusion)
Detailed Otrexup (methotrexate) risks & warnings »
  • Latex allergy
  • History of heart failure
  • Taking other immunosuppressant drugs
  • Age 65 or older
Detailed Enbrel (etanercept) risks & warnings »
    Coming soon.
    • Taking other immunosuppressant medications such as Kineret or Orencia
    • Age 65 or older
    • Active, chronic, or recurrent infection
    • Comorbidities
    • Taking other immunosuppressant medications, such as azathiprine or 6-mercaptopurine, at the same time as Humira (adalimumab)
    Detailed Humira (adalimumab) risks & warnings »
    • Taking other immunosuppressant drugs
    • Age 65 or older
    • Comorbidities
    • History of malignancy
    Detailed Remicade (infliximab) risks & warnings »
    • Taking other immunosuppressant drugs
    • Age 60 or older
    • Weak immune system
    • Long-term use of drugs that suppress the immune system
    Detailed Stelara (ustekinumab) risks & warnings »
    Pregnancy

    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.

    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.

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

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

    Interactions
    MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
    No interactions related info.No interactions related info.No interactions related info.No interactions related info.No interactions related info.
    • There are certain medicines that interact with Stelara (Ustekinumab) or will need the dose adjusted, especially if they are "narrow" therapy medicines like warfarin,
    Alcohol
    MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
    • Don't use alcohol, NSAIDs (anti-inflammatory medications), or stay in the sun too long.
    • You have to avoid alcohol and being in the sun too long.
    No alcohol related info.No alcohol related info.No alcohol related info.No alcohol related info.No alcohol related info.
    Weight
    MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
    No weight related info.No weight related info.No weight related info.No weight related info.
    • Although rare, Remicade (infliximab) can hurt your liver. If you have appetite/weight loss, stomach discomfort, vomiting, or dark urine, talk to your doctor. If you have yellowing of skin/eyes, talk to your doctor right away.
    No weight related info.
    Upsides and benefits
    MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
    • 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.
    • People taking Enbrel (etanercept) for rheumatoid arthritis showed significant improvement and were able to reduce the dose or stop their other RA medicines.
    • Enbrel (etanercept) can work for you even if other medications didn't help your rheumatoid arthritis.
    • Enbrel (etanercept) is the first biologic approved for moderate to severe rheumatoid arthritis. Since it has been around for a long time, its side effects are well known.
    • Many people have only minor or no side effects.
    • It's available as a pre-filled syringe and SureClick auto-injector pen which some people find more convenient and easier to use.
    Coming soon
    • Humira (adalimumab) is effective in reducing symptoms in all of its approved indications.
    • You can give yourself Humira (adalimumab) on your own at home rather than visiting a clinic or hospital.
    • Humira (adalimumab) treats many different autoimmune conditions.
    • Available in a single-use pen (Humira Pen) that may be more convenient and easier for some people to use.
    • People taking Remicade (infliximab) for ulcerative colitis, Crohn's disease, rheumatoid arthritis and other autoimmune conditions had more clinical response, clinical remission and symptom improvement compared to people who did not take Remicade (infliximab).
    • People who were also taking steroids for treatment were able to discontinue steroid use while taking Remicade (infliximab).
    • Remicade (infliximab) has almost two decades of clinical trial data and real-life experience with many people who have used it.
    • After the initial dosing, you only need to take Remicade (infliximab) every 6-8 weeks, depending on your condition.
    • Compared to other medications used to treat autoimmune conditions, Remicade (infliximab) has not been associated with as many harmful effects during pregnancy and breastfeeding.
    • Stelara (Ustekinumab) works throughout your whole body (systemic therapy) and may be better than just applying medicine to your skin (local therapy) for moderate or severe plaque psoriasis that covers large areas or many areas of your body.
    • It's used alone or together with another medicine called methotrexate for better results to treat active psoriatic arthritis.
    • Initial dosing might be a hassle, but then you only have to take it every 12 weeks.
    • People treated with Stelara (Ustekinumab) for psoriatic arthritis felt better and had more physical improvement compared to not using the medicine (placebo).
    Downsides and risks
    MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
    • 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.
    • Enbrel (etanercept) raises your risk of serious or life-threatening infections, including tuberculosis (TB).
    • Enbrel (etanercept) can increase the risk of lymphoma, leukemia and other cancers.
    • May not be the best choice if you have a history of heart failure or nervous system problems like multiple sclerosis.
    • You'll need to have regular blood tests before and during treatment to make sure you don't have any problems taking Enbrel (etanercept).
    • You could get injection site reactions such as redness, swelling, rash, itching, or bruising.
    Coming soon
    • Not first-choice treatment for rheumatoid arthritis.
    • Humira (adalimumab) is an injection and not an oral medication.
    • Humira (adalimumab) is expensive because there's no generic available yet.
    • Humira (adalimumab) lowers your ability to fight infection and in some cases 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.
    • You'll need to properly dispose of the needle, syringes, or Pen in a sharps container.
    • Humira (adalimumab) needs to be refrigerated until you use it, so if you're traveling, you'll need to carry it in a cooler with an ice pack.
    • You have to receive this medication at your doctor's office or clinic. You might need to be tested regularly for tuberculosis.
    • Remicade (infliximab) lowers your ability to fight infection and can cause serious illness. The risk is greater if you take other drugs that lower your immune system, or have a history of diabetes or tuberculosis.
    • Remicade (infliximab) can in some cases worsen symptoms of heart failure or neurologic conditions. People 65 years and older may have more side effects from this medication.
    • In rare cases, Remicade (infliximab) has been associated with cancers in children and adolescents.
    • No generic available, so it can be costly.
    • It's an injection.
    • Stelara (Ustekinumab) 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.
    • You have to get your first dose of Stelara (Ustekinumab) at your doctor's office. If you decide not to self-inject and don't have someone to do it for you, you'll need to continue to see your doctor for each dose.
    • You'll need to properly dispose of the needle and syringes in a special (FDA-approved) sharps container.
    • Because Stelara (Ustekinumab) needs to be refrigerated until you use it, if you're traveling, you'll need to carry it in a cooler with an ice pack.
    Tips from our pharmacists for people taking the medication
    MethotrexateEnbrelCyclosporineHumiraRemicadeStelara
    • 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.
    • Enbrel (etanercept) is available as an injection and a SureClick Autoinjector. You and your doctor can discuss which is best for you.
    • Enbrel (etanercept) is a medication that's injected under the skin (subcutaneous). Your doctor can give you your first dose, then let you self-inject it once you learn how to do it correctly.
    • Enbrel (etanercept) lowers your immune system's ability to fight infections including tuberculosis (TB), fungal, viral, and bacterial infections. Your doctor will check for TB and hepatitis B before starting Enbrel (etanercept). Let your doctor know if you come down with a fever, cough, or notice flu-like symptoms before or during treatment.
    • Enbrel (etanercept) can cause redness, rash, swelling, itching, or bruising at the site of injection. Do not inject into skin that's already red, bruised, or irritated. Rotate your injection areas to avoid skin reactions.
    • Keep Enbrel (etanercept) refrigerated, but let it rest at room temperature for 30 to 60 minutes before using it. Enbrel (etanercept) should not be used if kept at room temperature for longer than 14 days.
    • You should not receive certain vaccinations with Enbrel (etanercept). Discuss with your doctor about your vaccine history and whether you need to receive any vaccines before treatment.
    Coming soon
    • Humira (adalimumab) is a medication that's injected under the skin. Your doctor can give you your first dose, then you can inject yourself at home once you feel comfortable doing so on your own.
    • Humira (adalimumab) lowers your ability to fight infections, so it's important to let your doctor know if you have a fever, cough, or flu-like symptoms.
    • Tell your doctor if you have an allergy to latex since the syringe needle cover has latex in it.
    • Each time you use Humira (adalimumab), it's important to rotate the sites you chose to inject it in. Don't inject Humira (adalimumab) into skin that's red, bruised, or irritated.
    • As with all injection medicines, store securely away from children and throw away used syringes in an FDA-approved sharps disposal container, and not in the trash.
    • Remicade (infliximab) can in some cases cause a serious allergic reaction either immediately or several days after the treatment. Your doctor can give you medicines that will lower this risk.
    • Your doctor will test you for tuberculosis before taking Remicade (infliximab) and regularly 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.
    • You should not receive any live vaccines while taking Remicade (infliximab). Tell your doctor that you are taking Remicade (infliximab) before receiving any vaccines.
    • If you have any signs or new or worsening symptoms such as heart, neurological, or autoimmune conditions, talk to your doctor. Tell your doctor about symptoms such as bruising or bleeding.
    • Stelara (Ustekinumab) is an immunosuppressant medication that's injected under the skin (subcutaneous).
    • Your doctor will give your first dose then let you self-inject once you learn how to do it correctly.
    • It's very important you read the Medication Guide especially if you're giving yourself injections.
    • Usual dosing to build up the medicine in your body is a starting dose, then 4 weeks, then 12 weeks. Maintenance dosing is every 12 weeks.
    • You'll need to have a TB test before you start injecting Stelara (Ustekinumab).
    • Tell your doctor if you have an allergy to latex. The prefilled syringe needle cover contains a latex product.
    • Don't use/inject if the medicine contains any particles or is discolored.
    • Rotate your injection areas using front of the thigh, outer area of upper arms or lower part of your belly (not around belly button). Don't inject into skin that's red, bruised or irritated.
    • Stelara (Ustekinumab) can increase your risk of common infections, reactivate infections hidden in your body, and in some people, cause rare infections.
    • Serious and life-threatening nervous system and allergic reactions can happen immediately, days or months after starting Stelara (Ustekinumab). Stelara (Ustekinumab) can increase your risk of certain skin cancer.
    • Dispose of used syringes in a protective (Sharps) container. DON'T throw in the trash.
    • Don't get any live vaccines while you're taking Stelara (Ustekinumab). If you need to get a vaccine, ask your doctor first.
    Learn more
    More about MethotrexateSide effectsReviews & ratingsAlternativesFDA package insert
    Have you used Otrexup (methotrexate)?
    Worth itNot sureNot worth it
    More about EnbrelSide effectsReviews & ratingsFDA package insert
    Have you used Enbrel (etanercept)?
    Worth itNot sureNot worth it
    More about CyclosporineSide effectsReviews & ratingsFDA package insert
    Have you used Neoral (cyclosporine)?
    Worth itNot sureNot worth it
    More about HumiraSide effectsReviews & ratingsFDA package insert
    Have you used Humira (adalimumab)?
    Worth itNot sureNot worth it
    More about RemicadeSide effectsReviews & ratingsFDA package insert
    Have you used Remicade (infliximab)?
    Worth itNot sureNot worth it
    More about StelaraSide effectsReviews & ratingsFDA package insert
    Have you used Stelara (ustekinumab)?
    Worth itNot sureNot worth it