methotrexate vs rolapitant
Side-by-side comparison of methotrexate and rolapitant. 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
BCRP Substrates with a Narrow Therapeutic Index (e.g., methotrexate, topotecan, or irinotecan) Clinical Impact: Increased plasma concentrations of BCRP substrates (e.g., methotrexate, topotecan, or irinotecan) may result in potential adverse reactions [see Clinical Pharmacology (12.3) ].
Recommendation: Your doctor should monitor you closely for side effects since methotrexate has a narrow safety range.
Trexall, Otrexup
Varubi
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.
Varubi is a medicine that helps prevent nausea and vomiting caused by chemotherapy. It is used with other anti-nausea medicines.
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.
Varubi is used to prevent delayed nausea and vomiting in adults. This nausea and vomiting is caused by cancer chemotherapy. It is used for both the first and repeat treatments of chemotherapy.
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.
Varubi blocks a substance in your body called substance P/neurokinin 1 (NK1). This substance can cause nausea and vomiting. By blocking it, Varubi helps prevent these side effects from chemotherapy.
- • Mouth sores
- • Nausea
- • Abdominal pain
- • Changes in liver tests
- • Neutropenia (low white blood cell count)
- • Hiccups
- • Abdominal pain
- • Decreased appetite
- • Dizziness
- Rheumatoid arthritis 38,053
- Joint pain 36,283
- Pain 35,412
- Tiredness 29,061
- Feeling sick to your stomach 24,011
- Death 141
- Feeling sick to your stomach 79
- Feeling tired 50
- Reaction to the IV medicine 40
- Difficulty breathing 34
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.
You should not take Varubi if you are taking thioridazine or pimozide. These drugs can cause serious heart problems if taken with Varubi. Varubi can increase the levels of these drugs in your blood, leading to QT prolongation and Torsades de Pointes, which are dangerous heart rhythm problems.
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.
There is not enough information about Varubi use in pregnant women to know if it is safe. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if Varubi passes into breast milk. Talk to your doctor if you are breastfeeding.
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How to Read This methotrexate vs rolapitant Comparison
methotrexate is classified in the Disease-Modifying Antirheumatic Drug (DMARD) drug class, while rolapitant sits within the NK1 Receptor Antagonist (Antiemetic) 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 rolapitant has 344. 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 rolapitant blocks a protein that removes methotrexate from your system, which can cause the drug to build up to unsafe levels.. 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 rolapitant - 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.