Methotrexate injections

Posted , 7 users are following.

I've discontinued taking Sulphasalazine as it was making me increasingly nauseous and with each increase in dose the pain increased exponentially.  The rheumatologist has started me on Hydroxychloroquine and upped my Methotrexate to once weekly injections.  At the same time he also advised me that he doubts this regimine will help much due to the severity of the RA; however, I will need to continue with them for another three months to qualify for biologicals which provide a wider choice of drugs, or as I prefer to call them 'toxins'.

A question for those on injected methotrexate:   does a higher dose rate of methotrexate when injected have the same side effects as orals or are side effects more or less severe?    

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  • Posted

    Touch wood,I found that injections were much better.The GI side effects disappeared and so far no new ones have developed.Have been on injections 4months and only problem is it works for~6 days a week so for one day have to rely on painkillers (am still trying to work out therefore best day to take it) see rheumatoĺogy nurse today so will discuss with her.Good luck
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  • Posted

    Tony - you may get lucky and find the MTX works wonders for you by injection. My specialist got to the stage of WHY are these MTX tablets not working, and changed me over to MTX by injection.

    I am on 35mg once a week, have been told thats a lot, I inject into my thigh, somwhere I can reach easy, and be reasonably relaxed about what I am doing.

    My liver function is good and has been for quiet some time, this week, even though my ESR was 45, and CRP 17.5, thats the lowest CRP has been in years.

    Learn't also this week, from speciailist's locum about this, us MTX users should be having a 2 yearly CAT Scan as a precautionary measure, from shoulders through to hips. incl all internal organs, don't know wheather its a new policy, but never had one done before in 10 years of MTX tablets and injections.

    Hope you hav'nt had Tuberculosis preventative injections, most Kiwis have, especailly in the 1960's, apparently those preventative injections when I was 15, 50 years ago now, rule me out for biologicals, as I still have the antibodies in my bloodstream.

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  • Posted

    I was quite interested in MTX injections due to the fact my kidney function is down due to diabetes.   Most of the other meds I'm on also have negative effects on the kidneys so I wasn't keen on starting another oral med with the same effect.   Mind you, given I probably won't be around long enough to see my kidneys leave the room it's probably a moot point.   Funny thing I'm on the organ donor list, I think they'll probably laugh if they ever open me up and take a look inside!
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  • Posted

    Biologics aren't really 'toxic' in the same sense that methotrexate and other immunosuppressants are. Methotrexate works by blocking DNA synthesis, which slows the growth and replication of proliferating cells. This includes cells in the gastrointestinal tract, hair follicles, skin, liver, brain, and other areas, in addition to immune cells, and this is why it causes such widespread toxicity and side effects.

    Biologics, on the other hand, target a single cytokine or cell type, only in the immune system. They still carry the same increased risk of infections and cancer because they are suppressing part of the immune system, but the systemic toxicity of methotrexate isn't present. You'll likely feel much better once you are eventually able to switch to a biologic.

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  • Posted

    This are just a few of the side effects biologics (Humira) can bring on:

    Numbness or tingling

    Vision problems

    Weakness in your legs

    Chest pain

    Shortness of breath

    New joint pain



    Swelling of the face, feet, ankles, or lower legs

    Rash on your cheeks or arms that gets worse in the sun

    Trouble breathing or swallowing

    Fever, sore throat, chills, and other signs of infection

    Unusual bruising or bleeding

    Pale skin


    Red, scaly patches or raised, pus-filled bumps.

    If you check on the possible side effects from Methotrexate, Sulphasalazine and so on, there's not a lot difference in side effects.   Looking at the list I'd say biologics are every bit as as 'toxic' as Methotrexate, why split hairs?

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  • Posted

    There are of course side effects for all meds, but they re written down so we can seek immediate medical help / advice if we get those symptoms. My biologic has the risk that I may get a life threatening neurological disease. Did I hesitate to take it?- yes for half a second. I thought about the statistics( which is why I don't ever buy lottery tickets!) and decided there was minuscule risk and noted the warning signs. I would be diligent to get help if any arose.

    The biologic has changed my life . I am in remission. I have read the possible side effects for all the drugs I am taking- but now I ve put them to the back of my mind. They are nothing compared to the all over pain , fatigue and restricted movement I had previously.

    Hope you get the meds that work for you eventually- biologics have transformed outcomes for folks with RA and you are very fortunate if you end up on one. Sorry there s still pain to go through for now while your rheumy tries different stuff.

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  • Posted

    Rowbirdie - I think my rheumo specialist tears her hair out with me.

    When she thinks she has something that will work for me, it either has no effect, at all, or with leflunomide it nearly killed me, and GP was saying it can't be the Leflunomide, blood pressure isn't even listed, or it wasn't at the time but apparently it can be an issue for a very small number of patients, and guess what I fall into that very small number of patients.

    The blood pressure issue gave me a real fright, and GP saying it can't be that, but the leflunomide was the only new tablet I had added to the mix of tablets I was taking at the time, so I rang the maunfacturers direct and asked questions, they then asked who my Dr was, and did I have his phone number, only to happy to give them his name and number.

    Half an hour later GP Dr rings me and indentifies himself and tells me stop taking those tablets you were claiming in the surgery could be causing blood pressure problems, and hung up.

    Usless sod, have since fired him as my GP, he never even wrote a letter to rheumo specialist telling her what had happened, and he was supposed to be my first line of contact, and also my conduit for contacting the specialist and keeping her up to date between outpatient specialist hospital appointments, and checking my monthly blood tests, wonder with hind site, if he even did that.

    He never confirmed to me like my current Dr does, gets his nurse to ring me, and confirm they have received results of monthly blood test, Dr has reviewed and tells me all is OK, and or he needs to see me, and if necessary in front of me writes a report to the rheumo specialist, so I know exactly what is going on.

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    • Posted

      Oh Lyn ! That was tough. Good you were so diligent and contacted the manufacturers .

      yes, I accept there can be mild/ bad and downright dangerous reactions to these meds- and there s no knowing beforehand who ll be affected. I suppose that s the gamble we take- and we do have to speak up if it s going wrong- like Tony with his sulfasalazine.

      Just don't want anyone being put off trying biologics if offered them!

      lyn- I do hope your rheumy finds something in the end that will work for you....

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  • Posted

    I'm not put off biologics at all, in fact, I can't wait to start.   I'd rather live six months relatively pain free and be able to actually do something than live another 10 years in pain and unable to do anything.   Bring on the biologics, current medication just isn't helping at all.   

    I've discovered that Doctors don't necessarily note what you tell them.   In a recent consult with my Rheumatologist I told him my hands were virtually useless and I was in pain almost all the time.   By the time that info got to my GP in note form I was much better, had regained some use of my hands and pain was not a problem.   The only answer to this of course is to find a Doctor who listens to their patients - lots of luck there.

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