| Rheumatoid Arthritis
Otrexup vs Xeljanz
Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.Deep comparison between: Otrexup vs Xeljanz with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsXeljanz has a higher rate of injection site reactions vs Otrexup based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xeljanz but not Otrexup, including UnitedHealthcare
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Category
Otrexup
Xeljanz
At A Glance
SC injection
Once weekly
Folate analog metabolic inhibitor
Oral
Twice daily
JAK inhibitor
Indications
- Rheumatoid Arthritis
- Juvenile polyarthritis
- Psoriasis
- Rheumatoid Arthritis
- Arthritis, Psoriatic
- Ankylosing spondylitis
- Ulcerative Colitis
- Juvenile polyarthritis
Dosing
Rheumatoid Arthritis 7.5 mg SC once weekly; adjust dose gradually; doses greater than 20 mg/week associated with significant increase in serious toxic reactions in adults.
Juvenile polyarthritis 10 mg/m2 SC once weekly; adjust dose gradually.
Psoriasis 10 to 25 mg SC once weekly; do not exceed 30 mg/week; reduce to lowest effective dose once optimal response is achieved.
Rheumatoid Arthritis, Arthritis, Psoriatic, Ankylosing spondylitis Adults: 5 mg twice daily (XELJANZ) or 11 mg once daily (XELJANZ XR).
Ulcerative Colitis Induction: 10 mg twice daily or 22 mg once daily for at least 8 weeks (up to 16 weeks); maintenance: 5 mg twice daily or 11 mg once daily.
Juvenile polyarthritis Weight-based dosing in pediatric patients >=2 years weighing >=10 kg; patients >=40 kg: 5 mg twice daily.
Contraindications
- Pregnancy
- Alcoholism, alcoholic liver disease, or other chronic liver disease
- Overt or laboratory evidence of immunodeficiency syndromes
- Preexisting blood dyscrasias, such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or significant anemia
- Known hypersensitivity to methotrexate
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Adverse Reactions
Most common (>=10%) Elevated liver function tests, nausea/vomiting, ulcerative stomatitis, leukopenia, abdominal distress
Serious Bone marrow suppression, hepatotoxicity, interstitial pneumonitis, opportunistic infections, embryo-fetal toxicity, renal failure, pulmonary fibrosis
Postmarketing Toxic epidermal necrolysis, Stevens-Johnson syndrome, anaphylactoid reactions, reversible lymphoma, skin necrosis
Most common (>=2%) Upper respiratory tract infection, nasopharyngitis, diarrhea, headache, hypertension.
Serious Serious infections (pneumonia, cellulitis, herpes zoster, urinary tract infection), malignancy, thrombosis, major adverse cardiovascular events, gastrointestinal perforations.
Postmarketing Drug hypersensitivity (angioedema, urticaria), acne.
Pharmacology
Methotrexate inhibits dihydrofolic acid reductase, preventing reduction of dihydrofolates to tetrahydrofolates and thereby interfering with DNA synthesis, repair, and cellular replication; in RA the mechanism is unknown but may affect immune function, and in psoriasis it exploits the markedly increased rate of epithelial cell proliferation.
Tofacitinib is a JAK inhibitor that blocks JAK1/JAK2, JAK1/JAK3, and JAK2/JAK2 signaling, preventing phosphorylation and activation of STATs to modulate immune cell function and hematopoiesis.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Otrexup
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
Xeljanz
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (12/12) · Qty limit (11/12)
UnitedHealthcare
Otrexup
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Xeljanz
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (8/8) · Qty limit (8/8)
Humana
Otrexup
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (0/3)
Xeljanz
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Otrexup.
No savings programs available for Xeljanz.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.