Two medicines, side by side
Methotrexate vs prednisone
Methotrexate and prednisone are both labeled for leukemia and lymphoma and myeloma. Drugs@FDA records approvals of methotrexate since 1953 and of prednisone since 1955. Pharmacies paid $0.158 per methotrexate 2.5 mg tablet and $0.0643 per prednisone 20 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, methotrexate is a folate analog metabolic inhibitor and prednisone a corticosteroid.
Check it at the source: the methotrexate FDA label on DailyMed (effective May 27, 2026); the prednisone FDA label on DailyMed (effective April 22, 2025).
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
Highlights of the prednisone record
Prednisone (Meticorten) · label of April 22, 2025
Used for
From the label: indicationsPrednisone tablets and solutions are indicated in the following conditions: 1. […]
On the market
- Earliest approval on file
- February 21, 1955
- Generic labelers
- 45 labelers
- Pharmacy cost
- $0.0643 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 10
Source: FDA drug labels via openFDA (Methotrexate label of May 27, 2026, Prednisone label of April 22, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do methotrexate and prednisone differ on the record?
In FDA's classes, methotrexate is a folate analog metabolic inhibitor and prednisone a corticosteroid.
Only the methotrexate label carries a boxed warning.
Generics: methotrexate since 1979; prednisone since 1971 (Drugs@FDA).
| Methotrexate | Prednisone | |
|---|---|---|
| Labeled for | Rheumatoid arthritis, Psoriasis, Leukemia, lymphoma and myeloma, Breast cancer | Osteoarthritis, Asthma, Allergies, Herpes and shingles, Leukemia, lymphoma and myeloma, Crohn's disease and ulcerative colitis, Multiple sclerosis, Eczema (atopic dermatitis), Anemia, Organ transplant rejection |
| Pharmacologic class | Folate Analog Metabolic Inhibitor | Corticosteroid |
| How it works (label) | 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. | n/a |
| Half-life (label) | Elimination The elimination half-life of methotrexate is approximately 3 to 10 hours. | n/a |
| Earliest approval on file (Drugs@FDA) | December 7, 1953 | February 21, 1955 |
| First generic approved | September 5, 1979 | December 23, 1971 |
| Generic labelers (NDC) | 29 labelers | 45 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.158 per tablet (Methotrexate 2.5 mg tablet) | $0.0643 per tablet (Prednisone 20 mg tablet) |
| 12-month price change | -4% | -15% |
| Boxed warning | Yes | No |
| Shortage now | In shortage | No current entry |
| Recalls recorded | 8 | 10 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 489,791 | 499,950 |
| 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 methotrexate
- every medicine labeled for the same conditions