Methotrexate injection

I start mtx injections this coming up Tuesday. Hospital won't show me how to inject myself and neither will my gps clinic. I'm in US. So who do I turn to now? I have no idea how to fill the syringe so I get the right dose. I also don't know how to or where to inject it. Was not told to keep in ft fridge or not and no mention on prescription. Anyone know how and can help me? Or maybe someone can tell me where to go to get help?

26 Replies

  • The ones over in the UK come preloaded darling.xxxx

  • That's crazy, particularly given it's so important to inject the correct dose. I was shown how to inject & then had to do it myself in front of the nurse but from the get go it was with a prefilled syringe, quite different. Drawing MTX from a vial or bottle into a syringe is a whole different story, you need to know how to do everything from wiping the neck of the vial with an alcohol swab, how to work out your dose from ml's to cc's right through to injecting. Have you spoken to your Rheumy about this, who was it you spoke to at hospital that told you they would not show you how to inject? Do you think the Pharmacist where you get your prescriptions filled would be able to demonstrate the process for you?

  • I have a niece that is an RN she is going to teach me. I don't know a what I would have done if she had to work Tuesday night.

  • Oh good, though I'd still mention it to your Rheumy at your next appointment so none of his/her other patients get the same treatment, or lack of it! Injecting yourself can take some getting used to but once you've done it a few times you'll be fine & I hope you react nothing but positively to it.

  • Oh me too. I didnt do good at all with the pills.

  • It's years since I had to put together and fill a syringe. These days it will be a pre-prepared syringe or a pen unless your health area is really mean. There are good instructions for both on the metoject site... Here's the link for the pens, and they also have videos.

    Just make sure that your medical team book you for monitoring blood tests, if you've stopped taking the pill so don't have any arranged. And if you don't have any already in the diary start complaining. It's very important especially at the start.

  • No pens no prefilled needles just plain old syringes and vials of mtx. Apparently they are mean in the US.

  • Be very careful when using syringes & a vial as Methotrexate is a cyotoxic drug (ie cancer drug) & has to be treated with great respect, here in the UK we have to dispose of the syringes in a dedicated sharps bin just for cyotoxic drugs.

  • I have a sharps bin and the only syringe going into it is my mtx sharps.

  • It should be a special bin as it has to be disposed of differently than ordinary bins - well it does here in the UK

  • I will have to find out about that. I was not told that. Thanks for the information

  • It's the same in the US as the UK Penny, it has to be a purple lidded sharps bin that you'll dispose your MTX syringes in. Bins are colour coded & the same worldwide, purple is specifically for cyto's (meds which are toxic to certain cells). It's so healthcare workers are aware of what the syringes within have been used for until they're incinerated.

  • Okay. Will talk to parmacist tomorrow.

  • Thank you so much for this link! M x

  • Your doctor is lying to you. The US and Canada have auto prefilled MTx pens. Ask your pharmacist for the FDA approved Otrexup prefilled MTX pen. It was approved in the US in 2014. Another FDA approved MTX pen is called Rasuvo.

  • Okay thanks. I didn't know.

  • No worries Penny66. I hope the MTX works for you.

  • I am in UK and inject meth. We don't use syringes we have 'pen' type needles which are so easy. No measuring or any preparation just press it and it clicks and its done! Can't believe you are not getting help. Find out if you are getting syringes.

  • The Doctor who prescribed the methotrexate injection should also make sure you know how to preform the process go back to that doctor ,

  • Hi sorry to hear your problem.

    Here in the UK, my MTX injections are delivered to my home in prefilled syringes. Then updated to prefilled pens.

    You would normally inject about 5inches away from your belly button or in the tops of your front thigh.

    If using a pen it's really easy;

    1. Remove cap from pen or syringe;

    2. Clean and place on injection site (usually there will be an alco wipe in the syringe/pen box);

    3. If using a pen press pen onto injection site and press the button. Leave for about ten seconds and withdraw;

    4. If using a syringe, in the same injection sites as above, repeat cleaning process. Grab a fold of skin between your finger and thumb. Inject syringe into this site. Leave for about ten seconds and withdraw. Replace cover on needle.

    Hope this helps, there must be something about this on YouTube?

  • Hi I would go back to your doctor/clinic and ask them how you are going to give yourself an injection when you don't know how to ? Be persistant and remind them regarding their duty of care to you as a patient maybe . Only a suggestion I know you have a different system over there in the US but common sense must be in all of the professionals you are dealing with ?

    I hope you get help soon. Or ask for prefilled injections/pen instead they have been used here in England for over 10 years.

    I hope this has been supportive best wishes

  • In uk they are pre-filled pen x

  • It's nasty stuff, as well as the special bin to dispose of the pens I have a toxic spill clean up kit incase I spill any. The pre filled injections are quite expensive - I looked in the prescription book as I work in a hospital so maybe why in USA you have been given the syringe. Hope you get shown properly how to do it. Not an injection I would want to undertake having not been shown.

  • I am on the self injections and they had always been pre filled, you dont have to measure the dose or anything like that. They changed it to an even easier method now, I just grab a handful of thigh flesh (I've got quite a lot of flesh to grab unfortunately!) place it on the handful and press the big yellow button on the top, it automatically injects the correct amount which is in the pen style injection. I have found a video on youtube, try copying this link:

    it shows how to use the pen style injection, hopefully they will give you this type, if they dont ask them to change it, it is so much easier to do. Hope you get the help and support you need :) xxx

  • Nope my rheumatologist put me on self injections. If my insurance company would have approved the humira it would have been pre filled syringes.

  • I have been on "meth" for 4 years for my RA. I give myself the shot every Friday! They say it's best to pick a day and stick with it. I take 1ml and I give it in my tummy. Go around the all sides of the tummy. Not to close to the belly button. Pitch the fat and don't let go of the fat. If you let go you may end up getting a get bruise ( I have had lots and it hurts like a bitch) You DO Not put it in the fridge. I keep all my meds in a box up so no little hands can get to it. You should not get any info from your GP. Your RA specialist should be he one teaching and giving you the the info. I am from Canada and the GP told me I had RA at 32yrs old. My RA dr was not happy the GP said anything. You need to get in to see a specialist. They are called rheumatologist. Giving yourself a needle can be scary but just remember that it will help you and no flare ups. I didn't take it for a bit and I was in so much pain. As it stands right now I will never want t be off that meds. I take the mtx, folic Acid and plaquene miss spelled that word sorry! I have had NO issues for 4 years while being on the meds. But once you stop taking them you will hurt! I hope I was some help. Good luck. It gets better. Lorraine!

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