Metho injections

Good morning, I have been on Metho tablets for about 4 years and felt really unwell with them, swopped to injections about 10 weeks ago, to start with they were brilliant but as time has gone on felt more and more sick with every injection, for about 2 days.

Today just want to curl in a ball and go to sleep, feel extremely sick, has anybody else had this problem and is the only way to stop this feeling to come off it ????

Please πŸ’•πŸ’πŸ’πŸ’

37 Replies

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  • Are you taking folic acid with this? So sorry to hear this experience

  • Yes, I am

  • I'm the same, even though I take folic acid for 6 days. Ive asked if I can stop methotrexate, each time answer is no. Let's try reducing dose. I'm down to 15mgs but still have same sickness. I've tried taking it in the evening before going to bed.

  • Hi, does it work taking it at night ?

  • it did for a while, my rheumy nurse suggested it. Hope you find some relief soon. Anna

  • Hi Jillyanne - I used to have the same problem. I would be sick for a couple of days after my injections. I agree with Cathie - Folate will help mitigate some of that effect. I also noticed that after a few months, I started to feel better. If the Folate doesn't help, and you continue to feel worse, by all means, contact your doctor or nurse (not sure how things work in the UK)

  • Hi Jillyanne

    Sorry to hear you are suffering.

    Unfortunately I reacted to Methotrexate exactly like yourself and injections knocked me out for days afterwards. I was eventually taken off it and now I am on Biologics.

    You could try anti sickness pills to see if they give you a bit of relief. ....your GP would give you some if you give your surgery a call and explain how you are feeling.

    Hope you feel better soon bit if it's not getting better I would call your rheumatology nurse for advice.

    Best wishes x

  • I wasn't too bad on tablet form of metho but went onto injections because I was taking loads of meds including metho that I thought injections would be better. I felt very sick for about 24 hours afterwards. When I told RA doc this he told me I was wrong as the injections have less side effects than the tablet form! I KNOW HOW I FELT!!!! I'm at moment on tablet form again plus other RA meds.

  • Yes Jane1976,

    Don't you love it when someone else knows your suffering and pain, especially a doctor, whom most likely does not have R/A???

    Hope your feeling better!!!



  • Well said!

  • Yes, Cathie is correct. Don't forget the folic acid. Check with your doctor on that and I also was told not to take the folic acid on the same day as Methotrexate, pill or injection. It will render the Methotrexate not as effective.

    I'm one of the lucky ones, I've never been sick taking Methotrexate or any other R/A meds. Just wish they would work better some days, but over all, very blessed.

    Praying for you all!!! And really, actually I do and will.

    Keep Looking Up!!! Positive attitude is half the battle won!!! :)



  • Hi I used metrotexate ,AT the first sign of heavy bad side effect I stopped , your body can't not tolerate the medicine DO not take it !!! A lot of people get sick whit Metrotexate not WORTHED ,to use in your case , your body is trying to tell you to STOP ,Go and see your doctor and change med , there are plenty of option .... You do not need to suffer we suffer enouf whit our RA

    Good luck

  • Sorry I meant enough!

  • I tried Mtx pills & had really bad stomach pains, sickness & diaheoria. Had to call Doc out couple times & told to Stop taking it. So tried Mtx injection thing if it bypassed my stomach I would be ok. I was wrong - I had really bad sickness & diahoeria which completely wipes me out for 5 days. I stopped after my 3rd injection (16th this month) & the sickness & diahoeria still keeps coming bk even today.

    I'm still taking Gabapentin, Paracetmol, Tramadol. So Im gonna have to have camera down throat to see whats going on in my gut.

    I lose weight, very lathargic & miserable which is not like me but this bloody disease does this to us.

  • I couldn't tolerate high does of MTX and am now on Humira and have been able to drop MTX to 7.5 more nausea....hoorah!

  • I was on 17.5mg injections and I felt really sick so I reduced it down to 12.5 which helped, then after a while I was happy to increase it to 15mg and am ok. I have cyclizine (antiemetic) from GP to take if I need it. Good luck

  • I have been on methotrexate for about 20 years now I did go through a bout of sickness with it I lost almost 2st at the time they took me of it for about 3 /4 months ,the trouble starred when they uped the dose from 15mg to20 mg my body just couldn't take it I ended up with methotrexate poisoning ,(it happened at Christmas time which was awful ) so please do not ignore it , it could be it just doesn't suit you but please check I know the dose you get through injection is higher than the tablet form because it goes straight in the body and not the digestive system X please check it out XxDawn

  • Wow, thank you, very scary. Have just emailed my nurse, thank you

  • I wanted to say that my RA got much worse when I stopped taking mtx. It was stopped suddenly and my present Rheumy thought that was ill advised. So I'd advise anyone to keep trying if the side effects are bearable. I'm going to try to restart the injections as it boosted the biologic. It's a complicated balancing act isn't it

  • Thank you all, had a terrible day. Going to email my nurse, cannot live like this 😞😞😞😞

  • Hi I have been on. MTX on and off for about 17 years, I am also on Humira (nearly 8 years). I have finally finally got agreement for me to swap to Lefluminide. It took me complaining very time I went in to see the rheumatologist for the last 3 years that I really felt dreadful and it was ruining my week- nausea, extreme fatigue etc. To be fair I had tolerated the MTX pretty well for the first few years (even at 25mg) but as time went on I just felt ill all the time. I had dropped the dose to 15mg, then swapped to 10mg injections and I was still feeling the same. I start lefluminide next week. I know there are side effects with this medications as well but I cannot face even taking the MTX anymore so I have to give another drug a go. Best wishes.

  • Good luck πŸ€πŸ€πŸ€πŸ€πŸ€

  • I've been on methotrexate for about 10years both tablet and injection form. I prefer the injections as I can do them myself. I have never had any problems with either but feel a sharp after pain with the jab. They lowered my jab as I have major problems with my iron and also take 2000mg of sulfazalazine a day. Everyone is different but maybe get them to lower the mg on the injection. Is it just me or do u find ur rheumy nurse ignorant to ur needs!!??

  • Hi ellyb- I have 20mg mtx injection atm and 2000mg sulfasalazine along with other bits and pieces. My iron has gone down to 4.6! It should be 9. My hb is down to 10.4. A lot of my bloods are too high or too low including my esr-120 and crp 115 atm. I take ferrous fumarate 210 mg 3 times a day to no avail. I've had an endoscopy and all was ok.

  • Hi! I can't take iron tabs as they make me ill and dealing with work I couldn't stop to be sick! I had iron pumped into me but it didn't work and have had both camera's both ends 😦 with nothing showing up. My levels at last look were esr 112 and iron was 92. Had RA for nearly 10yrs and am only 38 😐 xx

  • That's hard for you ellyb😐have you had your b12 checked?

  • Nope but I'm sure that will be the next one lol feel like a pin cushion at times!! Xx

  • Might be worth it though x

  • I don't know about some doctors. It seems some of them are like a million miles away at times. Who knows??? Maybe some of them simply just take on too many clients, patients etc. In their defense, they did take an oath and throughout the years I've found most of them (not all) there to help you.



  • Hi ! I think my nurse is ok but my rheumatologist is awful, I feel all she wants to do I'd tick the boxes and get me out of her room !!,

  • Hi sorry for you! Folic shd be taken 48 hrs after injection. I swopped to bed time injection follwed by ginger to avoid nausea and foun injections better than the pills. good luck xx

  • I too am on MTX injections. I was prescribed first MTX preservative free then when I got it refilled it was listed with preservative. My pharmacist told me that MTX with preservative will give you those side effects like not feeling well. And it was true! I can't wait for my next refill-I'm going to tell them I have to have preservative free. It won't last long but at least I won't feel sick. It's hard to find stuff about it on the Internet, but it's true. With preservative has more side effects. Hope you feel better soon!!

  • I think taking methotrexate about an hour before you go to bed allows you to, hopefully, sleep through the worst feelings. If this doesn't work for you I would advise that you ask your rheumatologist to try you on a different drug. All the best.

  • Thank you, going to ask if I can have something different, because the awful feeling last for 2/3 days

  • Hiya Jillyanne. I'm not sure which dose you're on but often when changing from tablets to injections the dose prescribed is reduced. This is because less of the med is lost as it doesn't need to go through the digestive system but of course it means it's a stronger dose in effect so it may well be that the dose is too high for your body to cope with if you went straight to the same dose you were on with tablets. For example I went from 20mg tablets to 20mg injection & was near to giving up until it was reduced to 15mg & I'm not one to give up easily! Nowadays I'm on 17.5mg & just feel a little iffy the day after I inject but if my dose is increased to 20mg again I'm not well at all for 4 days & my liver has a benny. So, it can be finite which dose you tolerate but that needs to be weighed up against efficacy.

    I don't know if anyone's taken the time to explain to you how MTX works but, as has been said, folic acid can make quite a difference to tolerance as MTX is a folate antagonist, it inhibits the metabolism of folic acid & that is necessary in the production of key immune cells. MTX is intended to dampen them down but we still need some folate to feel well. We (those on MTX) need to replenish what is lost as we don't store it in our body, it's water soluble so not stored in fat cells. This means we don't keep any in reserve & adding MTX into the mix means we need to replenish what the MTX wipes out otherwise we can feel really bleuurrgh, similar to being anaemic. It can only takes a few weeks for your folate levels to fall too low if not enough folic acid is taken & feel poorly so it's quite important if we're to feel well to replace it. As well as taking folic acid we can also help keep folate levels topped up naturally with folate-rich veggies, I regularly eat spinach, broccoli & citrus fruits, can't stand liver though, school dinners put paid to that!! My Rheumy prefers to prescribe folic acid 6 days a week anyway because we what we don't need we naturally lose going to the loo but I know they each have their own thoughts on how often it's taken.

    Apols if you know all this, it's just I find it helps to understand why I'm feeling rubbish & if I know what the cause may be it makes & if there's some way to resolve it it's easier to accept the reason for continuing on a med, particularly if it's working. I'm also on sulfasalazine it makes me nauseous even on 1 tablet a day but since my GP prescribed an anti emetic l've been better. Of course if all avenues have been explored & there's still no difference it may be that MTX isn't for you & in which case I hope whatever your Rheumy suggest next does help, there's little point continuing on something you dread taking because of side effects. x

  • Thank you, I was on 12.5 tablets and went onto 12.5 injections and I take folic acid every day except on injection day BUT nobody told me the dose on the injections would be stronger???????

    Every time I g into th bathroom and see "those" injection, feel sick just looking at them.

    Have emailed my nurse and hopefully she will get back to me soon.

    Thank you very much for taking the time to replyπŸ’πŸ’πŸ’

  • Well yes, in effect it is because dose for dose less is lost through our systems because by injecting it goes straight into the blood stream not through our digestive tract, less is lost of the dose on it's journey. The dose is the same whether tablets or injections. It may be that a slightly lower dose, in my case 2.5mg, makes the difference for you too, certainly worth asking your nurse about. Let us know how you get on. x

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