Injecting methotrexate

January 19, 2016 at 9:20 am | Posted in arthrits, Me, rheumatoid arthritis, rheumatoid arthritis (RA) | 17 Comments
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Hmm, how many times have I read posts about self-injecting drugs and breathed a sigh of relief that I don’t have to do that? Too many to count. Well, that time has ended, my friends – I will be injecting my MTX in three weeks’ time, after my ‘education appointment’ with the hospital. Mind you, I gather from a small amount of on-line research that this is a very easy subcutaneous (under the skin) injection; not the sort of nasty intra-muscular injection that biologics users have to endure. It seems to be a simple (?!) question of using something like an epi-pen to squirt the MTX in with, but I will find out more when I go and get educated. Here’s hoping I get the sweet nurse I’ve been speaking to on the (yes, actually helpful) helpline, and not the bored and horrid nurse I’ve never liked from day one. We shall see. Either way I will endeavour to be a good girl, listen hard, take it all in and get it right first time. (Not getting it right first time could be messy!)

The reason I’m moving to this course is that I sometimes get stomach problems that may or may not be from the MTX and that many people who take the dose orally don’t get the full benefit as some of it is digested, rather than moving on to the bits it needs to go to in order to work. By injecting, I can keep to the same dose, rather than increasing and risking the side effects that go with that, but hopefully get more benefit from the dose as all of it will go straight to where it’s supposed to go. That’s the theory, anyway. Apparently there are no other advantages or disadvantages of injecting – other than the obvious mild unpleasantness I’m assuming for the injecting!




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  1. I inject MTX and it really isn’t a problem. I was like you rather apprehensive but it really doesn’t hurt and definitely benefits you regarding any stomach issues. The dose can be adjusted easily. I like you, had my appointment put back. I’m reluctant to contact the nurse. I still suffer pain under my feet and I thonk if the last appointment had gone ahead they would have increased my MTX. I’m now having to wait until March that is if I can bear the pain under my feet. I tend to exercise less because of that. No matter what pain medication I take I cannot get rid of the pain under my feet.

  2. Hi Sue, Good to hear that injecting isn’t a problem! So sorry about your appointment setback – at least with my team it turns out the helpline does help these days (unlike 8 years ago when my RA started!) Maybe it would be worth contacting yours? Trouble is they probably don’t think March is very far away – it is for us when we’re in pain though! Feet are an extra nuisance because they aren’t rated in the DAS score either!

  3. I did try ring my helpline. I rang to find out when to ring and when I did ring there was no reply. I then became almost stalkerish and rang 32 times. All calls went unanswered so I’ve not bothered since. I was that wound up by the end of the day that I’d almost forgotten what I was ringing for in first place. I was first diagnosed in 1998. I was initially diagnosed with lupus, then it changed to poly arthritis and then it changed again to RA within a space of 24 months. Then, almost to add insult to injury, I had a heart attack in 2005 and have not been able to take any anti-inflammatory drugs since that day. This means that my RA has had no means of control. Incidentally my cardiologist believed that my heart attack was brought on with the continual use of anti inflammatory drugs. My rheumatologist discharged me from his clinic because he got into an argument with the cardiologist as to whether I should or shouldn’t take anti-inflammatory drugs. So as you can see from my experience it’s not been exactly a smooth road to get me where I am today. Role on March at the LRI. Regards Sue

  4. Strewth – puts my bad helpline experience from 8 years (ish) ago into perspective! That’s just awful!! Well I hope the March appointment is actually useful after all that! I’m not actually taking any anti-inflammatories any more because they upset my stomach too much, but I am still taking MTX so there is control there, thank goodness. It would certainly be easier to be back on the Arcoxia or diclofenac though – except that I’d be …erm … how to put this delicately … tied to the bathroom!

    Flippers crossed for a really helpful appointment in March!

  5. Hi Polly: When I was first diagnosed with RA they put me on MTX orally. Since it was basically the only drug I took, I took a lot of it. I hated it because of the side effects and refused to go back on it after my hip surgery. I’ve successfully avoided it all these years until now. I just had my second MTX injection. I’ve had no side effects and it really seems to be working. I will tell you the first time you do your own injection (for anything) is really scary but once you get over that first time, it’s really not bad. I prefer the automatic pens rather than the syringes because you just have to put it next to your skin and push a button — not actually poke yourself with the needle. However, I’ve done both with biologics and my MTX comes in a vial and needles. You’re a brave penguin, so I know that you’ll do fine. (You’ll need to post and let us know how the training goes.) Good luck. Hope the knee is better!

  6. Oh wow Sue…what a journey you’ve had so far. Fingers crossed for the future x.
    PAPenguin – mtx pens are great! It all happens so fast that literally half the time I have to check the barrel to see if it injected in, because I felt NOTHING. Really! If I inject in my tummy (which is pretty wobbly and full of stretch marks) I just make sure I pull the skin taut and voilà! Well, as taut as possible, haha.
    The worst thing about the injection is the thought of it. 😆.

  7. Thanks for the encouragement, Carla and Jude! I’m getting less and less worried about it with everyone’s kind words and thoughts. Alas, I too have plenty of tummy to inject into, and it’s a pen rather than a syringe so I should be fine. 😊

  8. Even syringes aren’t too bad 🙂 as long as they’re nice ‘n’ sharp!

  9. Maybe, but I’d rather not have to find out!!

  10. Never say ‘never’!

  11. Hey Jude. Your tummy sounds like it’s the same design as mine😉. Ye,s I have to grab and inch (or two) and make sure it’s tight. It’s no problem then. Alternately injecting in the top of my thigh is no problem. As you say the injection is so fast you don’t feel anything. When I first started taking it, it was the noise that used to make me flinch but there was no pain. Occasionally it leaves a small bruise. I’d hate to think where use be without it though. All the best for the future and fingers crossed all stays stable. Sue

  12. I have been consciously working hard at not saying ‘Hey Jude’ but now Sue’s gone and done it for me! I’m hoping at my education appointment they give me the choice of tummy or thigh because my ‘gut feeling’ (pun noted, though not intended) is that I’d rather that than my time!

  13. Hi Pollyannapenguin,

    Oops, do you know I didn’t even notice that i’d done that (hey Jude). It’s this retched cough and cold i’ve had for the last four weeks. That is one thing with the MTX, your immune system is shot. I think I might end up laying off it until my cough/cold subsides. Of course the more I don’t sleep the more I hurt all over so it’s in my best interests to get a grip of this virus.

    Regarding where you inject the choice is yours. I vary it so as not to use the same injection site repeatedly.

    Kind regards



  14. Hi Sue, well ‘hey Jude’ does just slip out unless you fight it, I find! Sorry about the cold – there are some awful ones about. Just met up with a friend (with normal immune system and no RA) who’s still fighting off one she had before Christmas!!

    Hope my hospital agree it’s your choice where it goes. Last time I had a general steroid injection there it was bum or nothing – so humiliating and uncomfortable! Private hospital I’d been to previously put it in the thigh!

  15. Well! I had no idea all this ‘hey jude’ was going on! I wasn’t notified on wordpress, never mind. Is your education appointment soon Pollyanna? Sooner the better. If you were in my area you’d have to wait 3 blinkin’ months. tut.

    Hope your cold clears up soon Sue!

  16. Hey Jude, sorry can’t help myself now Sue’s started it – WordPress can be a bit temperamental – no idea why! Appointment is February 8th so not long at all. I think it was three months for my first MTX (oral) appointment years ago – don’t know if this was quicker because it relates to a flare, or if I was just lucky!

  17. Heehee :). I have that song in my head now!
    That’s good news, not long to go! 😊

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