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Methotrexate

Medication on the FAA's arthritis and colitis worksheets
Other names: Trexall

Taken for: Arthritis or colitisTaking it for something else? The entries here do not cover that use. The FAA may address it in the guidance for your condition. Ask your examiner.

FAA guidance

Acceptable with conditions.

Examiner

CACI: the examiner can issue when the condition's worksheet criteria are met. Applicants for first- or second-class must provide the worksheet's information annually; applicants for third-class with each required exam

FAA label

ACCEPTABLE

Source: FAA, CACI – Arthritis Worksheet. FAA date 29 April 2026. Checked by Crosscheck 14 October 2026

The FAA's CACI – Arthritis Worksheet lists methotrexate (Trexall), with or without daily NSAIDs, among its acceptable medications, for osteoarthritis or for rheumatoid (limited to joint), psoriatic or ankylosing spondylitis arthritis.

Track your medications
Compare FAA documents: methotrexateWhat each of the two FAA documents says, in plain wordsOpen

The CACI – Colitis Worksheet lists it among the medications for Crohn's disease, ulcerative colitis, microscopic colitis or irritable bowel syndrome; any other cause of colitis requires an FAA decision. Each worksheet applies with all its other criteria, and the examiner must note in Block 60 one of its statements, which include CACI qualified, and not CACI qualified and deferred.

Show the FAA's words: methotrexateThe official FAA wording: two passages, each with its document and dateOpen
FAA, CACI – Arthritis Worksheet · FAA date 29 April 2026
Acceptable causes are limited to:
Osteoarthritis* and/or
Autoimmune to include only the following: rheumatoid (limited to joint), psoriatic, or ankylosing spondylitis
One or more of the following with or without daily NSAIDs:
azathioprine (Imuran)
methotrexate (Trexall)
sulfasalazine (Azulfidine)
AME MUST NOTE in Block 60 one of the following:
CACI qualified arthritis. (Documents do not need to be submitted to the FAA.)
NOT CACI qualified arthritis. I have deferred. (Submit supporting documents.)
FAA, CACI – Colitis Worksheet · FAA date 29 April 2026
Cause of Colitis
Crohn’s disease, ulcerative colitis, microscopic colitis, or irritable bowel syndrome
Any other causes require an FAA decision.
Medications for condition
One or more of the following:
azathioprine (Imuran)
methotrexate (Trexall)
sulfasalazine (Azulfidine)
AME MUST NOTE in Block 60 one of the following:
CACI qualified colitis. (Documents do not need to be submitted to the FAA.)
NOT CACI qualified. I have deferred. (Submit supporting documents.)
Sources and dates: methotrexateTwo FAA documents, with the FAA's date and when Crosscheck checked themOpen

See also

  • Azathioprine

    Medication on the FAA's arthritis and colitis worksheets
  • Sulfasalazine

    Medication on the FAA's arthritis and colitis worksheets
  • Other medications

    Every medication in this group, with its answer and wait

Medication guidance alone does not determine whether a pilot is medically qualified to fly. The underlying condition, dosage, side effects, medication combinations, and certification history may affect FAA eligibility.

For informational purposes only. Not legal or medical advice.