MTX injected vs MTX pills? What are the pros and cons?

I'd like to make an informed decision on whether to inject mtx or remain on the pills. My new rheumy would like me to start mtx injections but he would allow me to remain on the pills if I were to divide my dose. 4 pills on friday morning and 4 pills on friday night.

I have no problems with IVs or needles for vaccines. I do turn my head when I get my blood drawn for tests....but I just can not seem to wrap my head around giving myself a weekly shot. Will this fear of self injecting dissipate? Is injecting mtx better than pills? I am now upping my dose to 20mg a week.

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37 Replies

  • Just learned that when dose up in 20mg injection enables better absorption.

  • Yes my doctor said the reason for splitting the dosage for the pills was for better absorbtion. I guess I'll bite the bullet and use the needles. I don't want to extend my side effects with splitting the dose of pills.

  • I was completely needle phobic. Long story but I would practically faint at the sight of a needle. Anyway, I needed to move to MTX injections to try to stop foul mouth & throat ulcers and was petrified. Had a lovely nurse who helped me through, and I still don't exactly relish the moment each week but 1,500 injections later it's fine (+ no more ulcers). My family were flabbergasted that I did it!

    If you inject the drug goes straight into the blood stream so you don't get any wastage. I was due to go up to 20mg, but with injecting stayed on 17.5 for several more years. I get about 5 seconds of nausea, and that's it. As against that, once it's in it's in. So no splitting of dose possible. And you might get very slight reactions at injection site (idon't, but it seems some do).

    And if you can get the pen rather than syringes then it's a total doddle. I've juat had to move back to syringes and they are a little more annoying. But neither is painful.

  • Ah, that explains why he wants me to inject .7ml (17.5mg) or if I remain on pills he wants me to go up to a divided dose of 20mgs mtx.

    I was taught how to inject with the syringes.

  • Oh my gosh double helix - 1,500 injections?? It seems to me like that would almost make me more needle phobic....

  • It's amazing how we all "get over" our fears eh?

  • Yes - out of self defense mostly... - ha ha

  • The first 1,000 were the worst....

    (I jest, you get used to it quickly and I always treat myself on injection night by going to bed early with a good book and a mug of hot chocolate to make it a pleasure rather than a misery...)

  • Nice - I might have to try that - ha ha

  • Hi there. I've seen on tv where heroin addicts destroy their veins through too many needle pricks. I've also had my veins turn bruised from nurses constantly missing my veins when I have to give blood. Do you experience any of these problems? How often do you have to stick yourself? Do you have to find a new vein each time to avoid aggravating the same one? I have stomach issues and may have to do the injectables as well if/when I have to switch from LDN (which isn't working yet) to Methotrexate. Thanks.

  • They are sub-cutaneous injections, so not into veins. You just find a bit of fat (which my belly can provide!) and pop the needle in anywhere. I very rarely even get a bruise, and it's only once a week so I can move the injection site around quite a lot. It is quite easy.

  • Oh ok. Once a week doesn't seem too bad. I thought I read where it's best to get a vein so that there is better absorption. I don't have any fat, but maybe my butt would work. Thanks for the reply :)

  • You jab your belly fat with the needle. I was told to pinch an inch of fat on my belly and put the needle in. No need to find a vein. ThankGod :)

  • I used to get bad headaches with the mtx tablets. I switched to injections which allowed me to drop my dose from 20mg to 17.5mg. I've been injecting mtx for about 6 months now using the metoject pens which are really easy to use. I do bruise and have a small spot of blood when I inject but otherwise it's absolutely fine. ☺

  • Thanks for your reply. I too get a headache for 2 hours with the pills. I really wasn't looking forwards to dividing the dose. 2 headaches in one day is not something to sing about :)

  • I have Folic acid 6 days a week as well.

  • I also take 5 mg folic acid 6 days a week. How much folic acid do you take?

  • 5mg

  • Trying upping your water intake on MTX day it worked for me.

    I was getting a horrid headache every week the day after MTX day (15mg orally). Then saw a few folk on Health Unlocked mention water.

    I drink 3 pints of water a day anyway, but upping it to 4 pints on MTX day five weeks ago and since then yippee - no more headaches!!

  • It's the best thing I ever did. I had bad stomach problems with the pills and switched to the Metoject 20mg. I had the same worries about needles but it is so easy and doesn't hurt, I am sure it is something to do with the click when you press the button. It is all done in seconds. My advice would be try it and you will wonder what you were worrying about.

  • If I'd have had the choice at the beginning I'd have run a mile but absolutely yes to the injections now. More gets into your system and it's only once a week - win, win situation ☺

  • I was supposed to transfer from tablets to injection as it's better as it by passes your liver and that's part it was effecting me.They took me off it completely for something else in end

  • did Mxt affect your bone marrow?

  • It's listed as one of the side effects.

  • Yeah. Very scary.

  • I use a syringe and found that if I take a warm bath before I inject my skin is softer and the needle just slides in with no blood or bruising and is quite easy.

    If I'm at home I don't use an alcohol swab as it makes my skin too dry even if I wait for the alcohol to dry. If I'm traveling I'll use the alcohol swab just to be on the safe side but then I get a little blood and a small bruise which is no big deal really.

    Like everyone said, after the first shot it just keeps getting easier and it's one less pill to swollow and think about every day and if you get less side effects then that's definitely a win!

    I wish you the best.

  • HI I would definitely vote for injections....I have tried both. In the end Mthx didn't suit me but injections were definitely better

  • I'm in the process of moving to injections too. The tablets made me so ill I ended up in hospital.

  • I was supposed to move to injections at the begining of the month, but I got scared and kept taking the pills. Having to divide the dose of pills has made my side effects last 3 days. So...I am now determined to use the needles. I'd rather be ill for one day than 3 days. Onwards and upwards :)

  • I was told that because I was put on 22.5mg it would be easier to inject and also works better and less side effects. I hated needles but these are not the old fashioned syringe type they are so easy even I can do it. I would definitely recommend. Good luck.

  • Hi suzannedale - I've only done the shots, because my doc was concerned about the upset stomach with the pills. As for the shots, I think it might make a difference if they are injector shots or if you have to give yourself one through the "pinch an inch" method. the injector is more of a count to three, look away and push down kind of thing, where the other is actually you directing the needle. So if you are squeamish, the injector pen might work better. The only problem I had was when I was still on MTX, my insurance company decided the injector pens were too expensive and they switched me to self inject. Best luck with whichever decision you make ;-)

  • I was given the old fashion type of syringes. I need to ask about the injector pens. I live in Canada and our medical system covers the cost. I wonder if the injetor pens are not covered? I need to find out about this.

  • Yeah - That is frequently how our medical decisions are made, ha ha. Let us know what you find out

  • I changed from Pills to injections due to side effects and while the side effects have not totally gone they are very much reduced . I have been on the same dose as you for the last three years. I too prefer to look the other way when anyone sticks a needle into me. I also was concerned about giving myself injections but my Rheumy Nurse was very good taking me through how to administer the dose and also Since the change from the older style injections to Pens I have found it even easier to administer.

  • Hi Suzanne, I stated on the tablets but they upset me and I couldn't tolerate them so I tried the self injecting with Metaject, it is honestly a doddle! I was just as concerned as you but found it really easy. when I first started it was a little pre filled dose with a very small needle, grab your thigh or tummy, I prefer thigh, and jab it in. Since then the injection has got even easier, it is now in a stick form, you just place the plastic tube against your skin and press the yellow button the top and it triggers the injection so you don't have to do any thing, it isn't painful, slight sting when you wipe the area with the medicated wipe afterwards but that's it, honestly it is much better than the pills, far fewer side effects as well. Good luck, once you get past the initial fear of doing it th first time, you will realise how problem free it is😊 X

  • I too had many side effects with the tablets. My rheumy suggested I try the injections and I thought there was no way I could do it. She gave me a Rasuvo pen to try and told me to bring it back if I was too scared to use it. I was so nervous and almost didn't do it but I did and was amazed at how painless and easy it was. That was 6 months ago and I don't plan on ever going back to the tablets. I have very minor side effects now and it was totally worth it to switch.

  • I felt incredibly nauseous on the pills to the point the thought of taking them would make me physically sick.

    Once on the injections I couldn't hack the injections as they made me ill for a few days after and feeling like cr*p.

    Hoping they work for you as they didn't for me but out of both of them I'd go with the injection.

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