Methotrexate Alternatives in Virginia
Compare generic and therapeutic alternatives to Methotrexate (methotrexate) available at Virginia pharmacies. Save up to 80% on your prescription — no insurance required.
Top Alternatives in Virginia
Leflunomide (generic Arava)
therapeutic
Alternative oral DMARD for rheumatoid arthritis
Avg cash price: $40/mo
Adalimumab biosimilar (Hadlima)
therapeutic
Biologic DMARD for RA — more powerful but far more expensive
Avg cash price: $1200/mo
Hydroxychloroquine (generic Plaquenil)
therapeutic
Mild DMARD — used in early RA or in combination
Avg cash price: $25/mo
Virginia Prescription Assistance Programs
Virginia Medicaid Rx (Medallion 4.0)
Prescription drug coverage for Virginia Medicaid beneficiaries through managed care organizations.
Eligibility: Low-income Virginia adults up to 138% FPL (expanded Medicaid 2019), children, pregnant women, and people with disabilities.
Frequently Asked Questions
Why is methotrexate used for rheumatoid arthritis?
Methotrexate is the anchor DMARD for RA — it reduces disease activity, slows joint damage, and has decades of safety data. At low weekly doses used in RA, it is very different from high-dose cancer chemotherapy.
What side effects should I watch for with methotrexate for RA?
Key monitoring points include: mouth sores (take folic acid 1 mg/day to reduce), liver function tests (regular LFT monitoring), pulmonary symptoms (rare pneumonitis), and blood counts. Do not drink alcohol regularly while on methotrexate.
Do I need to take folic acid with methotrexate?
Yes — folic acid 1 mg daily (or 5 mg weekly) significantly reduces methotrexate side effects like mouth ulcers, nausea, and liver toxicity without impairing its therapeutic effect.
Can methotrexate be combined with a biologic like Humira?
Yes — the combination of methotrexate and an anti-TNF biologic like adalimumab is more effective than either alone for RA. Methotrexate also reduces the formation of anti-drug antibodies to biologics.
How does methotrexate cost compare to biologic DMARDs?
Generic methotrexate costs $20–$40/month — compared to $1,000+ for biosimilars and $6,000+ for brand Humira. It remains the most cost-effective DMARD available and is recommended as first-line before biologics.