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Methotrexate vs. Plaquenil

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

Key takeaways

Methotrexate (Otrexup, Rasuvo) and hydroxychloroquine (Plaquenil) are both used to treat rheumatoid arthritis, but they have different uses and ways of working. Methotrexate is an antimetabolite that treats various cancers and non-cancer conditions like psoriasis and rheumatoid arthritis. It is given as an injection or may be taken by mouth as a tablet and works by blocking a protein important for cell growth. Hydroxychloroquine, on the other hand, is an oral medication that is a disease-modifying anti-rheumatic drug (DMARD) and an antimalarial. It helps treat rheumatoid arthritis and lupus by blocking certain immune system processes. Methotrexate can cause serious side effects like low white blood cells and kidney problems, while hydroxychloroquine can cause heart rhythm issues and eye damage. Methotrexate is not safe during pregnancy, but hydroxychloroquine might be an option for rheumatoid arthritis during pregnancy. Both medications are available in brand and lower-cost generic forms.

Methotrexate

(Trexall)

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Hydroxychloroquine

(Plaquenil)

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Summary for Methotrexate

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 Methotrexate

Cancer:

Non-cancer conditions:

Pros and Cons for Methotrexate

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 Methotrexate

  • 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 Methotrexate

  • 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

Summary for Plaquenil

Prescription only

Hydroxychloroquine (Plaquenil) is a non-biologic disease-modifying anti-rheumatic drug (DMARD) used to treat rheumatoid arthritis (RA) and lupus in adults. It's also an antimalarial medication used to prevent and treat malaria in adults and children. Hydroxychloroquine (Plaquenil) is taken by mouth, typically once or twice per day. Some of the more common side effects of this medication include nausea, vomiting, and diarrhea.

Indications for Plaquenil

Pros and Cons for Plaquenil

Pros

Cons

  • Need to take with food or milk
  • Interacts with commonly prescribed medications, such as certain blood sugar medications or antibiotics
  • Can't be used in children for lupus

Common Side Effects for Plaquenil

Warnings for Plaquenil

  • Serious heart rhythm problems
  • Build-up of phospholipids (a type of fat)
  • Eye damage
  • Severe skin and allergic reactions
  • Lower blood cell counts
  • Hemolytic anemia (low red blood cells)
  • Suicidal thoughts
  • Lower blood sugar levels
  • Worsening of certain medical conditions

Prices with our coupons for Methotrexate vs. Plaquenil

Price Card Drug Icon
Methotrexate72 tablets / 2.5mg
$27.81$233.76
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Price Card Drug Icon
Hydroxychloroquine60 tablets / 200mg
$17.74$51.45
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