Refrigerated medication question

I've been injecting MTX for 2 years. A while ago, it was changed to the refrigerated version. I've struggled since then and asked them to change to an easier syringe but got nowhere, so I just struggled. I'm causing massive bruises; they are completely black and purple and the size of my fist, no exaggeration! I mentioned it to my GP who ran some bloods tests but fortunately, everything is normal so we concluded it is my 'stabbing' method. She nagged me to tell my rheumy nurse but I kept forgetting which I know is silly....! Anyway, I'm starting Cimzia on Tues (yay!) and the nurse phoned today to tell me to take the meds out of the fridge before she comes to ensure it's prepared. It got me thinking....I've only ever injected MTX straight from the fridge and I wonder if it should be taken out for a bit to make it easier to inject. Any thoughts?

15 Replies

  • Most drugs that I know need to be out of the fridge for at least 20 to 30 minutes prior to injection. Check with your package instructions and also with your RA nurse.

    Do not inject till you have correct advice and information. I inject Humira 20 to 30 minutes after I have taken it from the fridge.


  • Unfortunately, they are no instructions on the MTX package and I've never been told anything about the new refrigerated version apart from "this needs to be stored in the fridge". I will phone this week before my next dose. Thanks. :)

  • I know there was a blog on site some time ago regarding Refrigeration of methotrexate. Maybe the site help line can give you updated info. I dont store mine in the fridge as mine still comes with instructions to store below 25'C.


  • I can't see any problem taking it out 30 mins before. I do that with my Cimzia.

    Is the MTX in prefilled syringes? As soon as you inject it it gets to 37C so letting it get to room temperature should not be a problem in my opinion.

  • Yep, it is in prefilled syringes and thanks for speedy reply!

  • I would not take a bulk supply out but single syringes should be ok. Is there any advice on information leaflet which comes with the MTX? Perhaps this could be in the how to store section?

  • Nope, it just comes in a little brown bag. It's got a prescription sticker and expiry date and says "store in fridge" but that's it.

  • Not a lot of help there !

  • Found a leaflet on MTX injections on NHS Wales which seems very good.

  • Hi Fruitycake, I never kept my MTX refrigerated.....there was an article just recently from the NRAS regarding storage temperatures so you need to check that out...I now take biologics and always always take it out of the has to warm up to room temperature , (i cheat and give it an hour) to make the injection fluid more viscose otherwise it would be so painful and hard to inject..


  • Can't find it. Was it this one?

  • If you go to the posts page, and look at the top right you will see that there's a pinned post from NRAS about MTX in a heat wave. But generally everything I've ever read about drugs that you inject says that it helps to bring them to room temperature first. But your pharmacist should be ale to tell you. Polly

  • Hi again, here is the post from the NRAS..

    Hi all

    Due to the unusually high temperatures across the UK at the moment, Medac Pharmaceutical company have had quite a lot of calls from people who were concerned that their Metoject injectable methotrexate had gone above room temperature. They have therefore passed this statement on to us:

    "Metoject syringes should be stored at or below 25°C. If room temperature is likely to be higher than 25°C, especially during this current hot spell or if the patient goes abroad on holiday, it is best to store Metoject in the refrigerator (2–8°C). The patient should remove the syringe from the refrigerator about 30 minutes prior to injection, to allow the solution to return to room temperature."

    Kind regards


    (NRAS Helpline)

  • Thanks. I don't use metoject, just the medicine in normal syringes but I assume the same applies.

  • Hi, I used to have MTX that had to be refrigerated, apparently because it did not contain preservative. Then I was given Metoject which has a preservative and is ok up to 25 degrees.

    As for bruising, I found that to be worse if I injected in my thighs (muscle). My muffin-top is more user-friendly as it is softer, but I can't see it cos of my ample bosom!! So my husband injects me, and the only time I bruise is if he hits a blood vessel. Yuk!

    Actually, I can't inject at all just now as I broke my wrist! Life is a bit tricky sometimes, isn't it?

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