Methotrexate Sodium
Brand names: Methotrexate, Trexall
At a glance
- Medicare prescriptions, 2024
- 2,134,402
- Medicare drug cost
- $51.3M
- Average cost per prescription
- $24.06
- Clinicians who prescribed it
- 22,646
Where it is prescribed
List the prescribers in any state, county, city or ZIP code →
What it is used for
Methotrexate tablets are a diydrofolate reductase inhibitor indicated for the: • Treatment of adults and pediatric patients with acute lymphoblastic leukemia (ALL) as part of a combination chemotherapy maintenance regimen • Treatment of adults with mycosis fungoides • Treatment of adults with relapsed or refractory non-Hodgkin lymphoma as part of a metronomic combination regimen • Treatment of adults with rheumatoid arthritis • Treatment of pediatric patients with polyarticular juvenile idiopathic arthritis (pJIA) • Treatment of adults with severe psoriasis
From the FDA-approved prescribing information (label dated May 2026). Full labels on DailyMed (opens in a new tab)
Boxed warning
WARNING: EMBRYO-FETAL TOXICITY, HYPERSENSITIVITY REACTIONS, SEVERE ADVERSE REACTIONS, and RISK OF MEDICATION ERRORS • Methotrexate tablets can cause embryo-fetal toxicity, including fetal death. For non-neoplastic diseases, methotrexate tablets are contraindicated in pregnancy. For neoplastic diseases, advise females and males of reproductive potential to use effective contraception. • Methotrexate tablets are contraindicated in patients with a history of severe hypersensitivity reactions to methotrexate, including anaphylaxis [Contraindications, Warnings and Precautions ]. • Methotrexate tablets when inadvertently administered once daily have resulted in death • Serious adverse reactions, including death, have been reported with methotrexate. Closely monitor for adverse reactions of the bone marrow, gastrointestinal tract, liver, lungs, skin, and kidneys. Withhold or discontinue…
The FDA’s strongest warning on a label. It doesn’t mean the drug is unsafe for most people; talk to your doctor or pharmacist before stopping or changing any medicine.
Who prescribes it
- Rheumatology 66.3%
- Nurse Practitioners 10.0%
- Physician Assistants 7.2%
- Internal Medicine 6.2%
- Family Medicine 3.8%
- Dermatology 3.0%
- General Practice 0.8%
- Pulmonology 0.4%
- Geriatric Medicine 0.4%
- Allergy & Immunology 0.2%
- Ophthalmology 0.2%
- Neurology 0.2%
All prescribers, by place, name or specialty →
Share of Medicare prescriptions written by each specialty. Select one to list its prescribers.
Trend, 2019–2024
Medicare prescriptions fell 4% from 2019 to 2024.
Biggest change by state since 2019
- Puerto Rico +34%
- Hawaii +11%
- Iowa +7%
- Maryland +6%
- Washington +3%
- Montana (smallest change) −22%
- West Virginia (smallest change) −17%
From CMS’s yearly state and national Part D summaries, which count every prescriber, including those CMS leaves out of its per-clinician data (fewer than 11 prescriptions). That is why these totals are higher than the count at the top of this page. Prescriptions include refills.
What it looks like
Pills from 4 makers on file. The same medicine can look different depending on who made it, so check the imprint (the letters and numbers on the pill) with your pharmacist if a refill looks different.
Alembic Pharmaceuticals Inc.
| Strength | Looks like | Imprint |
|---|---|---|
| 2.5 mg | yellow round tablet, 6 mm, scored to split in 2 | C7 |
Elite Laboratories, Inc.
| Strength | Looks like | Imprint |
|---|---|---|
| 2.5 mg | yellow round tablet, 6 mm, scored to split in 2 | E2 |
Hikma Pharmaceuticals USA Inc.
| Strength | Looks like | Imprint |
|---|---|---|
| 2.5 mg | yellow round tablet, 6 mm, scored to split in 2 | 54323 |
Sun Pharmaceutical Industries, Inc.
| Strength | Looks like | Imprint |
|---|---|---|
| 2.5 mg | yellow round tablet, 6 mm, scored to split in 2 | ORN57 |
Source: DailyMed (U.S. National Library of Medicine), from each maker’s FDA drug listing. A few makers are shown, not every one. Never take a pill you can’t identify; ask a pharmacist.
Industry payments about this drug
Drug makers reported $15,209 in payments to clinicians that named this drug in 2025 (meals, speaking, consulting and similar).
- Shorla Oncology Inc. $15,209
Source: CMS Open Payments, general payments (not research), program year 2025. A payment is not evidence of wrongdoing. Payments by doctor
Recalls and shortages
On the FDA shortage list now
- Methotrexate Preservative Free, Injection, 1 g (NDC 63323-122-50) (Fresenius Kabi USA, LLC)
- Methotrexate Sodium, Injection, 25 mg/1 mL (NDC 63323-123-10) (Fresenius Kabi USA, LLC)
- Methotrexate Sodium Preservative Free, Injection, 25 mg/1 mL (NDC 0703-3671-01) (Teva Pharmaceuticals USA, Inc.)
- Methotrexate Sodium Preservative Free, Injection, 25 mg/1 mL (NDC 0703-3675-01) (Teva Pharmaceuticals USA, Inc.)
- Methotrexate Sodium Preservative Free, Injection, 25 mg/1 mL (NDC 0703-3678-01) (Teva Pharmaceuticals USA, Inc.)
- Methotrexate Sodium Preservative Free, Injection, 25 mg/1 mL (NDC 16729-277-30) (Accord Healthcare Inc.)
- Methotrexate Sodium Preservative Free, Injection, 25 mg/1 mL (NDC 16729-277-35) (Accord Healthcare Inc.)
- Methotrexate Sodium, Injection, 1 g/40 mL (25 mg/mL) (NDC 61703-124-40) (Hospira, Inc., A Pfizer Company)
1 recall since 2020
- Sep 2023 · West-Ward Columbus Inc · Class III
Failed Tablet/Capsule Specifications: Tablets were observed to have an unsmooth surface with two tablets demonstrating illegible tablet identification and scoring.
Recalls usually affect specific lots from one maker, not every version of a drug. Class I is the most serious; most drug recalls are Class II. FDA recalls (opens in a new tab)
Sources: CMS Medicare Part D Prescribers by Provider and Drug (2024; prescriptions include refills, and CMS hides counts under 11 per prescriber); U.S. Food and Drug Administration, openFDA (drug labels, NDC directory, enforcement reports, drug shortages); CMS Open Payments 2025; ClinicalTrials.gov. General information only, not medical advice; not yet reviewed by our medical reviewer.