Reference guide
Methotrexate tablets: what to do during the shortage and what France has
Methotrexate tablets have been hard to find in Russian pharmacies since early 2026. This page gathers official figures and manufacturers’ statements with dates, and the forms of methotrexate registered in France. This is a reference, not a recommendation: only a doctor sets the dose and form and decides on substitution.
Published 2 November 2026.
What is known about the shortage
A timeline from dated reports and official statements.
- January 2026. Kommersant, citing the Russian rheumatology association Nadezhda, reported that Methotrexate-Ebewe tablets were missing from pharmacies in at least 34 regions. Sandoz explained that no tablets were supplied in 2025 because of restrictions at the production site, and expected 5 mg tablets by the end of January and 10 mg in the summer (GxP News, 23 January 2026).
- May 2026. Roszdravnadzor said that on 3 May more than 2.4 million packs of methotrexate in all forms were in stock and the last batch had been released into circulation on 27 April (RIA Novosti, 5 May 2026).
- October 2026. Six pharmacy chains in Saint Petersburg said they had no methotrexate tablets. According to Roszdravnadzor, more than 124,000 packs of tablets were in circulation, over 90 % of the previous year’s volume had been released in the first nine months of 2026, and the last release was on 17 September. Ozon Pharmaceuticals said it had no tablets in stock on 23 September and tentatively expected first deliveries towards the end of 2026 (Vecherny Sankt-Peterburg, 6 October 2026).
What methotrexate is
Methotrexate is an antimetabolite and immunosuppressant. Low doses are used for rheumatoid arthritis, psoriasis and other autoimmune diseases, high doses in oncology. It comes as tablets and as solutions for injection, including prefilled syringes.
Tablets or injections
Methotrexate tablets and injections are different forms. Only a doctor switches a patient from one to the other and sets the dose and schedule: mistakes in the methotrexate schedule are dangerous.
For rheumatoid arthritis, psoriasis and other autoimmune diseases methotrexate is taken once a week, not every day. Taking it daily by mistake has caused serious, sometimes fatal poisoning, which is why labels and packs highlight it. When the product or pack changes, check both the day of the week and the dose in milligrams with your doctor.
According to Anna Belokhvostova, head of the antitumour drug therapy department at the Tsyb Medical Radiological Research Centre, in oncology methotrexate is usually given by injection, tablets are used to a limited extent, and clinical guidelines provide alternatives if the medicine is unavailable (Vecherny Sankt-Peterburg, 6 October 2026).
What France has
According to BDPM, methotrexate tablets in France are sold as Novatrex (2.5 mg, Pfizer), Imenor (2.5 and 10 mg, Orion), Metotab (2.5 and 10 mg, Medac) and Methotrexate Accord (2.5 and 10 mg, Accord Healthcare). Imeth tablets are listed but marked as not marketed. The French database has no 5 mg tablets.
For subcutaneous injection there are prefilled syringes and pens — Metoject, Imeth, Nordimet, Izixate and Methotrexate Accord 50 mg/mL — in strengths from 7.5 mg; some solutions are for hospital use only. Every form of methotrexate is prescription-only in France (List I).
What to do if the tablets are missing
Steps that help avoid interrupting treatment.
- Check other pharmacies and chains; ask the pharmacy to place a subsidised prescription on deferred service.
- The State Register of Medicines (GRLS) lists methotrexate tablets by several manufacturers. Agree a medicine by another manufacturer with the same INN, strength and form with your doctor.
- Do not stop or change treatment on your own: if the tablets are missing, a doctor decides whether to continue with another product, switch to injections or change the regimen.
- If no suitable option exists in Russia, a LekInfo manager checks the BDPM details of the French tablets free of charge and explains the possible ways to obtain them.
What France has
Novatrex 2.5 mg
methotrexate tablets
Another brand with the same active ingredient. Prescription only, List I.
Made by Pfizer, 12 tablets per pack.
Imenor 2.5 and 10 mg
methotrexate tablets
Another brand with the same active ingredient. Prescription only, List I.
Made by Orion: 2.5 mg in packs of 24, 10 mg in packs of 10 scored tablets.
Methotrexate Accord 2.5 and 10 mg
methotrexate tablets
Another brand with the same active ingredient. Prescription only, List I.
Made by Accord Healthcare: 2.5 mg in packs of 24, 10 mg in packs of 10.
Metotab 2.5 and 10 mg
methotrexate tablets
Another brand with the same active ingredient. Prescription only, List I.
Made by Medac: 2.5 mg in packs of 24, 10 mg in packs of 10 scored tablets.
Imeth prefilled syringes
methotrexate solution for injection
Another form: injections. Prescription only, List I.
Syringes in several strengths from 7.5 mg. Only a doctor switches from tablets to injections and sets the dose.
See also
Questions and answers
Why are methotrexate tablets missing?
Sandoz attributed the lack of Methotrexate-Ebewe supplies in 2025 to restrictions at its production site, and Ozon Pharmaceuticals said in September 2026 that it had no tablets in stock. Roszdravnadzor meanwhile said tablets were being released into circulation, the last time on 17 September 2026.
When will methotrexate tablets be back?
There is no official date. In October 2026 Ozon Pharmaceuticals tentatively expected first deliveries towards the end of 2026. LekInfo does not track supplies to Russia.
Can injections replace the tablets?
Only if a doctor decides so. The switch from tablets to injections, the dose and the schedule are set individually.
Are methotrexate tablets sold in France?
Yes: Novatrex 2.5 mg, Imenor 2.5 and 10 mg, Metotab 2.5 and 10 mg and Methotrexate Accord 2.5 and 10 mg. The French database has no 5 mg tablets. All are prescription-only.
How often are methotrexate tablets taken?
For rheumatic and skin diseases, once a week on the same day; taking it daily by mistake is life-threatening. The doctor sets the dose and the day.
How do the French tablets differ from Methotrexate-Ebewe?
The active ingredient is the same, but these are products of other manufacturers: excipients, strengths and pack sizes differ. Agree any substitution with your doctor.
How do I get a consultation about methotrexate from France?
Send a manager a request with the medicine, form and strength from your prescription. They check the BDPM details and French dispensing conditions free of charge and explain the possible ways to obtain it.
This is reference information, not medical advice, advertising or an offer to sell. A doctor sets the dose and form and decides on substitution. Sources: Roszdravnadzor (RIA Novosti, 5 May 2026; Vecherny Sankt-Peterburg, 6 October 2026), Kommersant (GxP News, 23 January 2026), BDPM (ANSM).