Xatmep (Methotrexate)

Prescription medicineOnly Available By Prescription

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Strength Pack Size Qty
Pack Size

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What if I find a lower price with another pharmacy?

We guarantee the lowest price on all of our prescription products. If you find your medications cheaper at any other recognized licensed mail order pharmacy, we will not only match their price, we will beat it by 25% of the difference. It is our 125% price match guarantee!

Example: If you find a product on Canada Drugs Direct for $50.00 and find the same product for $40.00 at another mail order pharmacy, we will provide you with a $12.50 discount, bringing your total to $37.50.

To get the discount please make sure to mention the price match to the customer service team when they call to collect payment for your order. Or call toll free at 1-888-904-8467 to place the order through the phone.

Terms & Conditions of Program

  • Guaranteed lowest price is only valid at the time of sale.
  • We will only match the current advertised price.
  • Products must be identical and in stock at the time of placing an order with a licensed mail order pharmacy. They must be an online Canadian pharmacy with an address in Canada.
  • Products must be authentic in brand and size (same manufacturer, same country of manufacture, same pack size, same strength and same quantity).
  • Products must be new. We cannot match the price of any used, short expiry or expired product.
  • Price match can only be issued over the phone with our customer service team. Please note at this time we cannot offer price matching for the products Ozempic or Saxenda.
What is a Generic Drug?

A generic drug is a copy of the brand-name drug with the same dosage, safety, strength, quality, consumption method, performance, and intended use. Before generics become available on the market, the generic company must prove it has the same active ingredients as the brand-name drug and works in the same way and in the same amount of time in the body.

The only differences between generics and their brand-name counterparts is that generics are less expensive and may look slightly different (eg. different shape or color), as trademarks laws prevent a generic from looking exactly like the brand-name drug.

Generics are less expensive because generic manufacturers don't have to invest large sums of money to develop a drug. When the brand-name patent expires, generic companies can manufacture a copy of the brand-name and sell it at a substantial discount.


Xatmep is a prescription chemotherapy agent used to treat acute lymphoblastic leukemia (ALL). It is also used to treat polyarticular juvenile idiopathic arthritis (pJIA).

Fact Table






60% at lower doses, less at higher doses

Legal status


Chemical Name


Elimination half-life

3–10 hours (lower doses), 8–15 hours (higher doses)

Dosage (Strength)



Not Advised


Trexall, Rheumatrex, Otrexup

Protein binding

35–50% (parent drug), 91–93% (7-hydroxymethotrexate)

PubChem CID






ATC code






Routes of administration

By mouth, intravenous (IV), intramuscular (IM), subcutaneous injection (SC), intrathecal


Take Xatmep exactly as prescribed by your doctor. The dose is unique to each person.


The active ingredient is methotrexate.


Common drug-drug interactions can include:

  • Abrocitinib
  • Acitretin
  • Alcohol 
  • Baricitinib
  • BCG Products
  • Cladribine
  • Coccidioides immitis Skin Test
  • COVID-19 Vaccine
  • Deferiprone
  • Dengue Tetravalent Vaccine
  • Denosumab
  • Dexketoprofen
  • Dichlorphenamide
  • Dipyrone
  • Echinacea
  • Fexinidazole
  • Foscarnet
  • Influenza Virus Vaccines
  • Inhibitors of the Proton Pump
  • Leflunomide
  • Lenograstim
  • Lipegfilgrastim
  • Natalizumab
  • Nitrous Oxide
  • Nonsteroidal Anti-Inflammatory Agents
  • Palifermin
  • Pimecrolimus
  • Poliovirus Vaccine
  • Polymethylmethacrylate
  • Probenecid
  • Rabies Vaccine
  • Ropeginterferon Alfa-2b
  • Rubella- or Varicella-Containing Live Vaccines
  • Ruxolitinib
  • Salicylates
  • Sipuleucel-T
  • Sulfonamide Antibiotics
  • Tacrolimus
  • Talimogene Laherparepvec
  • Tertomotide
  • Tofacitinib
  • Trimethoprim
  • Typhoid Vaccine
  • Upadacitinib
  • Yellow Fever Vaccine


If lymphoma develops while taking this drug, stop taking Xatmep.

Speak to your doctor before receiving any immunizations.

Use caution if you are pregnant or trying to become pregnant.

Side Effects

Common Xatmep side effects include:

  • Abdominal distress 
  • Abnormal cranial sensation 
  • Acne vulgaris
  • Agranulocytosis
  • Alopecia 
  • Anemia 
  • Anorexia
  • Aphasia
  • Aphthous 
  • Aplastic 
  • Arterial thrombosis
  • Arthralgia
  • Azotemia
  • Blurred vision
  • Bone fracture 
  • Bone marrow depression
  • Burning sensation of the skin 
  • Cerebral thrombosis
  • Chemical arachnoiditis chills
  • Chest pain
  • Chronic obstructive pulmonary disease
  • Cognitive dysfunction 
  • Conjunctivitis
  • Cough
  • Cryptococcosis
  • Cystitis
  • Cytomegalovirus disease 
  • Decreased libido
  • Decreased serum albumin
  • Deep vein thrombosis
  • Defective oogenesis
  • Defective spermatogenesis
  • Dermal ulcer
  • Dermatitis 
  • Diabetes mellitus
  • Diaphoresis
  • Diarrhea 
  • Dizziness 
  • Drowsiness
  • Dysarthria
  • Dyschromia 
  • Dysuria
  • Ecchymoses
  • Enteritis
  • Eosinophilia
  • Epistaxis
  • Erythema multiforme
  • Erythematous rash
  • Exacerbation of psoriasis 
  • Exfoliative dermatitis
  • Eye pain
  • Fatigue
  • Fever
  • Furunculosis
  • Gastrointestinal hemorrhage
  • Gastrointestinal ulcer
  • Gingivitis
  • Gynecomastia
  • Headache 
  • Hematemesis
  • Hematuria
  • Hemiparesis
  • Hepatic failure
  • Hepatitis 
  • Herpes simplex infection
  • Herpes zoster 
  • Histoplasmosis 
  • Hypogammaglobulinemia
  • Hypotension
  • Impotence
  • Increased liver enzymes 
  • Infection 
  • Infertility
  • Interstitial pneumonitis
  • Intestinal perforation
  • Leukoencephalopathy 
  • Leukopenia 
  • Lymphadenopathy
  • Lymphoproliferative disorder
  • Malaise
  • Malignant lymphoma
  • Melena
  • Menstrual disease
  • Mood changes 
  • Myalgia
  • Myelopathy 
  • Nausea 
  • Neutropenia
  • Nocardiosis
  • Nodule
  • Non-Hodgkin's lymphoma
  • Non Immune anaphylaxis
  • Oligospermia
  • Osteonecrosis 
  • Osteoporosis
  • Pancreatitis
  • Pancytopenia 
  • Paresis
  • Pericardial effusion
  • Pericarditis
  • Pharyngitis
  • Pneumonia
  • Polyarticular juvenile idiopathic arthritis
  • Proteinuria
  • Pruritus 
  • Psoriasis
  • Pulmonary alveolitis
  • Pulmonary embolism
  • Pulmonary fibrosis
  • Respiratory failure
  • Retinal thrombosis
  • Rheumatoid arthritis
  • Seizure
  • Sepsis
  • Severe neurotoxicity 
  • Skin necrosis
  • Skin photosensitivity 
  • Skin rash 
  • Speech disturbance
  • Stevens-Johnson syndrome
  • Stomatitis 
  • Stomatitis
  • Thrombocytopenia 
  • Thrombophlebitis
  • Tinnitus
  • Tissue necrosis
  • Transient blindness
  • Tumor lysis syndrome
  • Upper respiratory tract infection
  • Vaccinia 
  • Vaginal discharge
  • Vasculitis
  • Vomiting 


Xatmep. Greenwood Village, CO: Silvergate Pharmaceuticals, Inc.; 2017.

IMPORTANT NOTE: The above information is intended to increase awareness of health information and does not suggest treatment or diagnosis. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.

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