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What the FDA labels say about taking them together

Methotrexate and sulfasalazine

Methotrexate's FDA label (Rasuvo) of December 15, 2025 names sulfasalazine in its drug interactions section; the sulfasalazine label PlainMeds reads does not name methotrexate. The methotrexate label: “Therefore, patients receiving concomitant therapy with Rasuvo and other potential hepatotoxins should be closely monitored for possible increased risk of hepatotoxicity.”

Check it at the source: the methotrexate FDA label on DailyMed (effective May 27, 2026, Accord Healthcare Inc.); the sulfasalazine FDA label on DailyMed (effective May 29, 2026, Pfizer Laboratories Div Pfizer Inc).

What does the methotrexate label say about sulfasalazine?

Rasuvo label (Medexus Pharma Inc., December 15, 2025), drug interactions

Therefore, patients receiving concomitant therapy with Rasuvo and other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) should be closely monitored for possible increased risk of hepatotoxicity.

Otrexup label (Antares Pharma, Inc., January 31, 2025), drug interactions

Therefore, patients receiving concomitant therapy with Otrexup and other potential hepatotoxins (e.g., azathioprine, retinoids, and sulfasalazine) should be closely monitored for possible increased risk of hepatotoxicity.

Source: FDA drug label (Rasuvo, NDA205776), Medexus Pharma Inc., effective December 15, 2025 (SPL set d0075461-0e7e-4967-9c9b-d6440e912c0e), via openFDA

Source: FDA drug label (Otrexup, NDA204824), Antares Pharma, Inc., effective January 31, 2025 (SPL set 9ab8ce16-f7de-41d4-a4c8-1c742621b6d5), via openFDA

Source: FDA drug label (Methotrexate), Accord Healthcare Inc., effective May 27, 2026 (SPL set 874c7f43-a3be-4236-89cc-24c44e3c5813), via openFDA; the full label on DailyMed

What does the sulfasalazine label say about methotrexate?

Sulfasalazine's label (effective May 29, 2026) does not name methotrexate in these sections. A label lists what its studies and reports found; it is not a complete list.

Source: FDA drug label (Azulfidine), Pfizer Laboratories Div Pfizer Inc, effective May 29, 2026 (SPL set ddbe69f3-bd55-45f3-a64f-f60226c744c4), via openFDA; the full label on DailyMed

These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.

Both medicines on the record

29Methotrexate generic labelers
5Sulfasalazine generic labelers
MethotrexateSulfasalazine
Labeled forRheumatoid arthritis, Psoriasis, Leukemia, lymphoma and myeloma, Breast cancerCrohn's disease and ulcerative colitis, Rheumatoid arthritis
Boxed warningYesNo
Pharmacy cost (NADAC)$0.158 per tablet 2.5 mg tablet$0.199 per tablet 500 mg tablet
Shortage nowIn shortageNo current entry

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

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