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Imuran vs. Trexall

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

Key takeaways

Azathioprine (Imuran, Azasan) and methotrexate (Trexall) are both medications used to treat rheumatoid arthritis, but they have different uses and belong to different drug classes. Azathioprine is an immunosuppressant that weakens your immune system to prevent it from attacking your joints or a transplanted kidney. Methotrexate, on the other hand, is an antimetabolite that can treat cancer at high doses and autoimmune conditions like rheumatoid arthritis and psoriasis at lower doses. Azathioprine is taken daily, while methotrexate is usually taken once a week. Both medications can increase your risk of infections and require regular blood tests, but methotrexate is also associated with serious side effects like liver damage and lung problems. Additionally, methotrexate is often taken with folic acid supplements to reduce side effects, which is not the case for azathioprine. Both medications are available in generic forms, making them more affordable.

Imuran

(azathioprine)

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Methotrexate

(Trexall)

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Summary for Imuran

Prescription only

Imuran (azathioprine) is a medication used after kidney transplantation and also for rheumatoid arthritis. It's not a first choice medication because of many side effects. Your provider may also use Imuran (azathioprine) for other indications as well, although these are off-label (not FDA-approved) uses.

Indications for Imuran

  • To prevent the body from rejecting a transplanted kidney
  • Rheumatoid arthritis

Pros and Cons for Imuran

Pros

  • Works well for the treatment of rheumatoid arthritis, although it's not commonly used unless other medications don't work
  • Lowers the pain, stiffness, and swelling caused by rheumatoid arthritis
  • Available in a generic form which is more affordable
  • Can be used in people who have had a kidney transplant and are planning to become pregnant

Cons

  • Regular blood tests are required
  • Raises risk of getting an infection
  • Not a first choice medication because of many side effects

Common Side Effects for Imuran

  • Nausea
  • Vomiting
  • Leukopenia (lowering of white blood cells in the body)
  • Infections

Warnings for Imuran

  • Cancer
  • Fewer Blood Cells
  • Greater Risk for Infections
  • Liver Damage

Summary for Trexall

Prescription only

Methotrexate (Trexall) belongs to a drug class called antimetabolites. It’s used as chemotherapy at high doses to kill cancer cells and treat different cancers, such as acute lymphoblastic leukemia (ALL). At lower doses, methotrexate (Trexall) is considered a disease-modifying antirheumatic drug (DMARD) that treats certain non-cancer conditions, such as rheumatoid arthritis (RA). This medication is a tablet that you take by mouth. For most conditions, it’s taken once a week, but for some, it’s taken more often than that. Methotrexate (Trexall) side effects include mouth sores, nausea, and stomach upset.

Indications for Trexall

Cancer:

Non-cancer conditions:

Pros and Cons for Trexall

Pros

  • Taken by mouth, so a good option for people who don’t like needles
  • A non-steroidal option for autoimmune conditions (e.g., rheumatoid arthritis, psoriasis)
  • Doesn’t typically cause hair loss or weight gain

Cons

  • Might cause nausea and mouth sores
  • Can raise your risk for infection
  • Requires regular office visits and lab tests to check for serious side effects

Common Side Effects for Trexall

  • Mouth sores
  • Nausea or vomiting
  • Diarrhea
  • Stomach upset
  • Dizziness
  • Tiredness
  • Chills
  • Fever
  • Infection
  • Higher liver enzyme levels in the blood
  • Low white blood cells
  • Low platelet levels

Warnings for Trexall

  • Harm to unborn baby
  • Allergic reaction
  • Low blood cell counts
  • Damage to the digestive tract
  • Liver damage
  • Lung problems
  • Serious skin problems (including skin burns)
  • Kidney damage
  • Risk of serious side effects with dosing errors
  • Effect on folic acid levels in the body
  • Serious infections
  • Serious nervous system problems
  • Risk for new cancers
  • Tumor lysis syndrome
  • Changes to your ability to have children (infertility)
  • Higher risk for side effects if you have extra body fluid

Prices with our coupons for Imuran vs. Trexall

Price Card Drug Icon
Azathioprine90 tablets / 50mg
$28.95$111.97
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Price Card Drug Icon
Trexall4 tablets / 10mg
$205.12$256.02
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