Self injection methotrexate

Posted , 6 users are following.

Hi all,

Well, my most recent Rheumy review ended with me starting on Sulphasalazine in addition to methotrexate. We are also weaning me off steroids..... thankfully (before I resemble a small whale!!!!)

It has also been agreed I should move to self administered sub cut methotrexate.

Has anyone any experience of self administering methotrexate? I am on 25mg of oral methotrexate and don't want to have to take less as I am slowly feeling better....... I guess I am asking if they build up the injectable dose or give by injection the dose.......

Any thoughts or advice is gratefully received



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6 Replies

  • Posted

    Hi Anthony. I’ve been injecting subcutaneous methotrexate for the last 18 months or so. This was to improve response and reduce digestive issues. It has been good in both respects. I think at the time another option considered was to increase the oral dose, but I opted for injections. So I am on 20mg in a pre-loaded 1ml syringe. Some countries offer a spring loaded pen but I have had no issue with the syringes. There are some useful videos online showing method. I also had a short intro from a nurse, using a fake flesh pad, she went through safe handling and disposal. 

    I was so averse to doing my first weekly injection! I dithered about, fearing the sight and action of poking a needle into myself. Finally I gritted my teeth and the moment I had done it that fear was a bit of a laugh. A fairly short, very fine needle. In most cases it is almost painless. Though for me, generally thighs are more sensitive.

    I follow a rotation of injection sites as I have been directed, each week I move from one to the next: left hand side stomach; LHS thigh; RHS thigh; RHS stomach; then we’re back at the start. 

    One or twice I have had a bruise at the site and once a few drops of blood where I must have gone through a little capillary I guess, but otherwise never more than at most a half a millimetre size bead of blood. 

    I dispose of sharps containers with the chemist when full and I go to buy another one, but it takes me months to fill one.

    I hope you get good results.

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  • Posted

    Hi,when I changed to injection the dose was kept the same.Pre filled injection pens and was taught how to use them and dispose in bin (this is changed when collect each 12wk prescription ).First dose supervised by nurse to check it was done right.
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  • Posted

    When I was changed over to injectable, they knew that I was not taking up via my stomach, but specialist gave me the same dose 35mg.

    My biggest fear was my needle phobia, not crazy about needles, but learnt with a patient GP to draw up the meds, check right amount, and then inject myself, for me in my front upper thigh worked out to be the best, as have lost ability to twist myself enough to inject elsewhere, he supervised me about three times on a Friday last appt of the day, which gives you the weekend for recovery times, if any reaction at all, usually just a little tired the day after, not unusual.

    Have since weaned myself, with no ill effects, GP watches my ESR & CRP with me, monthly,  six monthly specialist appts, but always thinking I may get another flare, so keep the MTX on hand and GP asks if I need repeats of meds, not yet, but will only take another big upset for me, and I am off again into a flare, fingers crossed I can avoid for a long time.

    Weaned myself because of night sweats, driving me nuts, waking up soaking wet, needed a beach towel for my bed, sometimes twice a night, turned out it was the MTX combined with other meds for me, seems I am very sensitive to some meds, after 15 years of using without mishap.


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  • Posted

    I used it for a year or two, some time back.

    If your question is would they jumped from 25mg oral to 25mg injectable, I can't be sure, but I don't see why not.

    I used the tiny diabetic needles...My only problem was the colour, stupidly. For some reason I was averse to putting yellow liquid inside me. Odd, no?

    You haven't asked a specific question so not sure how I can help. Not that there's much else to say, to be honest.

    God luck with making the shift!

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  • Posted

    Hi Anthony. I was changed to sub cut methotrexate back in 2009 as I was constantly feeling nauseated with the tabs. I transferred straight on to 25 mgs with no problems.

    My GP prescribes the inj with my monthly prescription and I take the sharps bin back there when I need a new one and it's replaced. I have monthly bloods for FBC and to check liver/ kidney function. I didn't need the nurse to check on me but if you have never done injections before someone will supervise you a few times. I live in the UK and that's what we do here. Not sure about other countries although I imagine it will be similar. I hope the transfer goes well for you.

    Best wishes, Elspeth

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    • Posted

      Hi Elspeth,

      Thanks for replying. I am in the UK too so I'll probably have the same arrangement. My hospital use a private company to deliver the injection pens and sharps bin and then send a nurse to the house before I can do first injection........ I'm hoping that this Monday is the last time I have to take methotrexate by tablets and the last week I have to put up with side effects (gets embarrassing at work when I'm in and out of the bathroom.... sorry, probably too much info 😂wink

      Never thought I'd be so please for injections 😂🤣

      Thanks again


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