methotrexate vs rabeprazole
Side-by-side comparison of methotrexate and rabeprazole. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
minor Known Drug Interaction
Methotrexate Clinical Impact: Concomitant use of rabeprazole with methotrexate (primarily at high dose) may elevate and prolong serum levels of methotrexate and/or its metabolite hydroxymethotrexate, possibly leading to methotrexate toxicities. No formal drug interaction studies of methotrexate with PPIs have been conducted [see Warnings and Precautions ( 5.9 )]. Intervention: A temporary withdrawal of rabeprazole sodium delayed-release tablets may be considered in some patients receiving high dose methotrexate administration.
Recommendation: Your doctor might have you stop taking rabeprazole for a short time if you are receiving high doses of methotrexate.
Trexall, Otrexup
Aciphex
Methotrexate is a drug that can treat certain cancers, rheumatoid arthritis, psoriasis, and other conditions. It works by slowing the growth of cells in the body.
Rabeprazole (Aciphex) is a medicine that reduces the amount of acid your stomach makes. It belongs to a class of drugs called proton pump inhibitors (PPIs).
Methotrexate can treat acute lymphoblastic leukemia, a type of cancer, in adults and children. It also treats mycosis fungoides, a skin lymphoma, in adults. Additionally, it treats relapsed or refractory non-Hodgkin lymphoma in adults. For non-cancer conditions, it treats rheumatoid arthritis in adults, polyarticular juvenile idiopathic arthritis (pJIA) in children, and severe psoriasis in adults.
This medicine can treat several conditions caused by too much stomach acid. It can heal damage to your esophagus from acid reflux (GERD). It also treats heartburn, stomach ulcers, and conditions like Zollinger-Ellison syndrome where the body makes too much acid. Rabeprazole can also be used with antibiotics to get rid of a bacteria called H. pylori that can cause ulcers.
Methotrexate blocks an enzyme called dihydrofolate reductase. This enzyme is needed for cells to grow and multiply. By blocking this enzyme, methotrexate slows down the growth of cells, especially cancer cells and cells that cause inflammation in arthritis and psoriasis.
Rabeprazole works by blocking the enzyme in your stomach that produces acid. This helps to lower the amount of acid in your stomach. Lowering stomach acid helps to heal damage and relieve symptoms.
- • Mouth sores
- • Nausea
- • Abdominal pain
- • Changes in liver tests
- • Pain
- • Sore throat
- • Gas
- • Infection
- • Constipation
- Rheumatoid arthritis 38,053
- Joint pain 36,283
- Pain 35,412
- Tiredness 29,061
- Feeling sick to your stomach 24,011
- Feeling sick to your stomach 1,543
- Loose, watery stools 1,318
- Aches or soreness 1,314
- Pain in your head 1,284
- Difficulty breathing 1,276
Methotrexate can cause serious harm to an unborn baby, including death. If you are pregnant, you should not take this medicine for non-cancer conditions. If you are taking it for cancer, talk to your doctor about the risks. This medicine can also cause severe allergic reactions and other serious side effects that can be life-threatening. Contact your doctor immediately if you experience any signs of infection, lung problems, or kidney problems.
Taking PPIs like rabeprazole may hide signs of stomach cancer, so tell your doctor if your symptoms don't improve. This medicine may also increase your risk of bone fractures, especially if you take it for a long time or at high doses. Long-term use may also cause low vitamin B12 or magnesium levels. Contact your doctor right away if you experience signs of hypersensitivity.
Methotrexate can cause birth defects or fetal death if taken during pregnancy for non-cancer conditions. If you are pregnant or plan to become pregnant, talk to your doctor. Do not breastfeed while taking methotrexate, as it can pass into breast milk and harm your baby.
It is not known if rabeprazole is safe to use during pregnancy. Talk to your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.
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How to Read This methotrexate vs rabeprazole Comparison
methotrexate is classified in the Disease-Modifying Antirheumatic Drug (DMARD) drug class, while rabeprazole sits within the Proton Pump Inhibitor (PPI) class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, methotrexate has 162,820 submissions while rabeprazole has 6,735. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to rabeprazole can keep methotrexate in your body longer than usual, which might lead to dangerous levels of the drug in your blood.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between methotrexate and rabeprazole - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.