Two medicines, side by side
Dexamethasone vs methotrexate
Dexamethasone and methotrexate are both labeled for rheumatoid arthritis, psoriasis, leukemia and lymphoma and myeloma. Drugs@FDA records approvals of dexamethasone since 1958 and of methotrexate since 1953. Pharmacies paid $0.193 per dexamethasone 4 mg tablet and $0.158 per methotrexate 2.5 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Methotrexate's other strengths are brand-only: $21.76 per mL (Xatmep 2.5 mg/mL oral solution). In FDA's classes, dexamethasone is a corticosteroid and methotrexate a folate analog metabolic inhibitor.
Check it at the source: the dexamethasone FDA label on DailyMed (effective June 6, 2025); the methotrexate FDA label on DailyMed (effective May 27, 2026).
Highlights of the dexamethasone record
Dexamethasone (Decadron) · label of June 6, 2025
Used for
From the label: indicationsAllergic States Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, and serum sickness. […]
On the market
- Earliest approval on file
- October 30, 1958
- Generic labelers
- 60 labelers
- Pharmacy cost
- $0.193 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 8
Highlights of the methotrexate record
Methotrexate (Rasuvo) · label of May 27, 2026
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 is contraindicated in pregnancy. For neoplastic diseases, advise females and males of reproductive potential to use effective contraception [see Contraindications (4), Warnings and Precautions (5.1), Use in Specific Populations (8.1 , 8.3) ].
Used for
From the label: indicationsMethotrexate tablets is a dihydrofolate reductase inhibitor indicated for the: Treatment of adults and pediatric patients with acute lymphoblastic leukemia (ALL) as part of a combination chemotherapy maintenance regimen ( 1.1 ) Treatment of adults with mycosis fungoides ( 1.1 ) Treatment of adults with relapsed or refractory non-Hodgkin lymphoma as part of a metronomic combination regimen ( 1.1 ) Treatment of adults […]
On the market
- Earliest approval on file
- December 7, 1953
- Generic labelers
- 29 labelers
- Pharmacy cost
- $0.158 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 8
Source: FDA drug labels via openFDA (Dexamethasone label of June 6, 2025, Methotrexate label of May 27, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do dexamethasone and methotrexate differ on the record?
In FDA's classes, dexamethasone is a corticosteroid and methotrexate a folate analog metabolic inhibitor.
Only the methotrexate label carries a boxed warning.
Generics: dexamethasone since 1971; methotrexate since 1979 (Drugs@FDA).
| Dexamethasone | Methotrexate | |
|---|---|---|
| Labeled for | Asthma, Eczema (atopic dermatitis), Leukemia, lymphoma and myeloma, Herpes and shingles, Crohn's disease and ulcerative colitis, Multiple sclerosis, Osteoarthritis, Rheumatoid arthritis, Psoriasis, Allergies, Anemia, Pain | Rheumatoid arthritis, Psoriasis, Leukemia, lymphoma and myeloma, Breast cancer |
| Pharmacologic class | Corticosteroid | Folate Analog Metabolic Inhibitor |
| How it works (label) | n/a | Methotrexate inhibits dihydrofolic acid reductase. Dihydrofolates must be reduced to tetrahydrofolates by this enzyme before they can be utilized as carriers of one-carbon groups in the synthesis of purine nucleotides and thymidylate. |
| Half-life (label) | n/a | Elimination The elimination half-life of methotrexate is approximately 3 to 10 hours. |
| Earliest approval on file (Drugs@FDA) | October 30, 1958 | December 7, 1953 |
| First generic approved | October 20, 1971 | September 5, 1979 |
| Generic labelers (NDC) | 60 labelers | 29 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.193 per tablet (Dexamethasone 4 mg tablet) | $0.158 per tablet (Methotrexate 2.5 mg tablet) |
| 12-month price change | -26% | -4% |
| Boxed warning | No | Yes |
| Shortage now | In shortage | In shortage |
| Recalls recorded | 8 | 8 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 304,163 | 489,791 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Methotrexate label, drug interactionsOral antibiotics (including neomycin) Antifolate drugs (e.g., dapsone, pemetrexed, pyrimethamine and sulfonamides) Oral or intravenous penicillin or sulfonamide antibiotics Aspirin and other nonsteroidal anti-inflammatory drugs Highly protein-bound drugs (e.g., oral anticoagulants, phenytoin, salicylates, sulfonamides, sulfonylureas, and tetracyclines) Hepatotoxic products Proton pump inhibitors Weak acids (e.g. …
Source: FDA drug labels via openFDA
What next?
- Alternatives to dexamethasone
- every medicine labeled for the same conditions