MTX injections

[jeanjack]

Does MTX in injection form always avoid the nausea associated with MTX in tablet form or does it still depend on the individual as to how they tolerate it?

[nomoreheels]

Unfortunately we all react to drugs differently as I'm sure you know & MTX is no different. Some people get on well with tablets, other don't & swap to injections & still suffer & have to try another alternative. Only time will tell but MTX is still considered the gold standard which is why it's usually the first point of treatment & is worth persevering with if you can. I've had good results since changing to injections but I'm sure others will tell you differently. I had nausea on the tablets which completely went once on injections & I'm even better taking folic acid 6 times weekly. Still have a couple of iffy days after injecting, not wanting to each much & fatigue but far better than on tablets.

Hope this helps & it you're able to tolerate it better than the tablets.

[jeanjack in reply to nomoreheels]

Thanks nomoreheels. It confirms what I have been reading about injections lately but its helpful to have real people's experience. I am trying very hard to stay on MTX tablets and at the moment am trying different ways of taking them along with more folic acid. It's going okay at the moment with just a little nausea the day after MTX. I think it's just because after 14 months of taking the tablets I am fed up of feeling the same side effect every week that I am striving for perfection. I think that I will either have to accept that the small amount of nausea is just the way it is going to be or try the injection but as you say it's a bit like Russian roulette and may have the same side effect as the tablets.

[nomoreheels in reply to jeanjack]

No probs. I've found it's so empowering to be on here & get different perspectives, especially with treatments. My list to take to my next appointment is ever growing because of it. I've found it particularly hard with the different attitude to treatment here compared with what I've been used to in the past. This of course could just be my Rheumy & the way she's tied by the NHS & local funding but I'm finding it difficult not seeing the same person each time & the length of time between appointments, which I've little doubt has affected me as I'm no where near as controlled as a year ago. Venting here as it's not really relative to your problem but it does seem that we're somewhat left to our own devices & were it not for sites such as this a lot of us could be suffering far more than necessary but for the experiences of others. The internet is also invaluable. I find after appointments it's my first point of call & surely second guessing isn't the right way to go. Right, said my piece now!!

[jeanjack in reply to nomoreheels]

Totally agree. I have learned such a lot from this site. I also search the internet for RA answers but it helps to know how others are coping. I think the reason we all use this site is because only fellow sufferers know what we are going through and there always seems to be someone who can relate to whatever problems we are experiencing at the time.

[nomoreheels in reply to jeanjack]

Exactly my point of view. But surely we shouldn't be relying on it though as some of us have to. It should be more about support & sharing experiences rather than being forced in a way to ask questions the professionals should be answering & advising us about. Don't get me wrong, I think it's an invaluable site but through necessity having to be used almost as a crutch as so many are experiencing troubles with communicating with Rheumys. Maybe it's just me & my mood right now as I'm frustrated with the care I'm receiving at the moment & it's clouding my view. I do seem to be doing rather a lot of moaning at the moment, even I recognise it!!

By the way, don't beat yourself up about striving for perfection with your meds. With RD that's not always possible but the more you feel comfortable with the meds & find the way to take them that suits you the benefits outweigh the side effects & if you do go the injection route I hope you'll have even fewer troubles as I found. Just had a thought, have you asked your GP for an anti-emetic to help with your nausea if you're not intending to change to injections any time soon? I don't know what other meds you're taking but if your also taking NSAIDs are you also taking a ppi such as omeprazole? I only ask as if you don't this could maybe have an effect on your tum & how you're feeling. Bit of a shot in the dark but worth a thought.

[jeanjack in reply to nomoreheels]

Hi nomoreheels, I am only taking sulfasalazine along side MTX. I do take an omeprazole tablet to see if it will help on the day after MTX but it doesn't seem to last very long.

[nomoreheels in reply to jeanjack]

I may be wrong here but I don't think a ppi is usually prescribed with DMARDS alone. Was it your Rheumy who told you to take it? Don't know if you're taking it alongside meds for another condition, but if it's not lasting very long that could be because the dose is too low or you need to take it more often than the day after, if this is how you were advised to take it.

[Hidden]

Hi Sender. I changed to injections because of nausea and other side effects. My rheumy hoped that I might be able to tolerate a higher dose by injection. I found that it was more effective for my RD by injection but I came off MTX because the nausea and other side effects became intolerable with the injections too. After quite a long time off it I restarted a few months ago and even at a low dose by injection I'm struggling again. So I'm one of those who struggles with MTX in whatever form I take it so it seems. However I would still choose the injections over the pills because it does at least seem to be more effective if it doesn't have to pass through the digestive tract. Twitchy

[JEM95]

I switched to injections as I suffered from tummy upsets, cramps, nausea, fogginess and general yukkiness. I lost a whole weekend once as I couldn't leave the bathroom!

I am much, much better on injections and it has enabled me to increase to 20mg, which has helped with the RA.

Yes, I do still have some side effects, such as a lively tummy from time to time but the benefits far outweigh the MTX side effects. I also upped my folic acid (saw a typo on here the other day - frolic acid - I like that!) to six days out of seven.

I'm feeling pretty good at the moment.

As we are all different, have different variations of this awful condition and react differently to different drugs I would say keep an open mind and try different things. Once you have found something that suits you it is great.

[dillie]

i have been on tablets and now injections, having struggled with dreadful side effects. i have found the consultants awful, belittling and dismissive. sometimes, i feel at my wits ends with it all, so many meds, as you say its a russian roulette. i am so relieved to find i am not the only one who struggles with this disease, and the the mix of meds. this website is god send, i wish the consultants would read these posts!! i feel so left to my own devices at times and having to work out what is causing the nausea etc - by the way, i stopped taking naproxen at the weekend and my GI problems have gone right down, it might the MTX injections combining with other drugs that are making you feel rough. but the pain has been horrendous over the weekend which makes me thing the MTX isnt really working. sorry this post is so random, feeling very overwhelmed - just know you are not alone! hope you feel better soon

[jeanjack]

Thanks everyone for your input. I am still experimenting at the moment with a new regime of splitting MTX into 3 doses throughout the day ( Sunday ) as well as increasing folic acid. Although I have found it better that taking MTX all in one go I still hate that sicky Monday feeling. I am going to give it a couple more weeks but if no improvement I will probably have to bite the bullet and make a decision about changing to injections!!!

[Graham7]

I have been taking MTX injections for 18 months of 20 mgs with no side effects, and take a Folic acid tablet every day except for the day of my injection. My blood tests have all been good and I feel great with no sign of nausea

[jeanjack in reply to Graham7]

So glad it's working for you. However from what I have read it's still very hit and miss with injections as to whether you will still have side effects. I'm still trying different things to alleviate the nausea. I admit it is not that bad and I cope with it better these days but would just love to not have it at all. Have taken 17.5mgs throughout the day today so will see how I feel tomorrow. I have got until July when my next RA appointment is to make a decision.

[jersey48]

Good morning... I have changed from tablets to injections and have noticed a change...very little fog head and not feeling so sick!! Hoping now to increase my dose which I could not have done on the tablets as felt so awful.