NRAS
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Switching over to Metoject Pens

Hi all!

I switched over to Metoject prefilled pens 20mg from tablets this week and injected for be first time Thursday.

On Friday everything I ate tasted funny, all the things I would usually like had an earth like taste! Has anyone else found this? Could it be due to the injections?

I also suffered with really bad nausea and headache - does anyone know any good remedies to make this go away?

Thanks

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Hi

I got the nausea and headaches with the pills when I first started them. My nurse upped my folic to six days and told me to up my water content. If the pen anything like pills my headache went over few weeks kept curtains closed a lot.

Did you not get the symptoms with the pills.

Sorry not much help

🙂

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Thanks nuttyshirlz, the water intake is a good point. I spent most of Thursday in the hospital for X-rays and blood tests so I might have been dehysdrated.

With the pills I got the symptoms but I was also sick a lot which is why they decided to swap me over. The other option was staying on my MTX tablets but then adding sulfasalazine back again.

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Ah I’m on sulfasalazine too lol hopefully you should be ok soon x

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Thanks, I hope so 😊

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Hiya Zoppy89 & welcome. I take it you've changed over to injections from tablets? Can I ask what dose tablets you were on? If it's the same or higher that could explain your side effect symptoms.

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Thanks nomoreheels. Yeah I have been on 20mg of tablets and then they swapped me across to the injections.

When I first started MTX 5 years ago I was on 20 mg. if then dropped to 15 when they added hydroxychloroquine and sulfasalazine but slowly they have taken me off them and put the MTX back up again about 3 months ago.

It was so frustrating as I felt so ill and I was trying to celebrate my birthday. Hoping that he side effects won’t stay around for too much longer

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I thought that might be the case, you've essentially gone up a dose. I was on 20mg tablets & started 20mg injections but my liver objected so down to 15mg I went & was fine. The thing is the bioavailability is greater by injection, that means your body takes more of the med than tablets so in effect you've gone up a dose or even two. That of course means that side effects can increase. When we take tablets some of the dose is lost by it having to go through the body & the digestive system. Injecting however goes straight into then bloodstream meaning the body retains more of the dose, hence the likelihood of feeling bleurgh.

I'd definitely report this to your Rheumy or nurse, it could be they'll reduce the dose, maybe increase your folic acid if you're not on max dose. Increasing the amount of water you drink on MTX day helps with headaches & other side effects, the nausea, may be eased by eating some stem ginger, ginger nuts or anything else with ginger. The taste may go the longer you're injecting, thinking back I had a metallic taste early on.

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Zoppy I'd like to echo what nomoreheels has said - I just switched to Metoject, first one yesterday, and the rheumy nurse said that whereas I was on 22.5mg in tablets, I was being given 20mg in the pen, as it was that much more effective taken directly into the bloodstream and 22.5 in injection form would be like 25mg in tablets.

I couldn't believe how easy and painless the injection was - it hurt a lot less than the Humira one I do fortnightly! Let's hope Metoject does the trick and that the earthy/metallic taste goes away for you.

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Hi Zoppy. I'm assuming you've swapped from tablets and that you're on folic acid, drinking loads of water etc. I was on tablets and then 25mg metoject and have found that food doesn't taste "right" and foods previously a standard part of my diet, like meat, have become revolting to me. Cutting coffee has helped with my nausea. We're all different, though, and what helps some may not do it for you. It could easily be one of those things that stops being troublesome with time but if you keep a diary you'll be able to see progress. I hope that helps

J

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Thanks for the reply Gnarli. A diary is a good plan. Hope all is well with your injections.

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The injections are so easy and painless. So much better. I started to dread having to swallow all those tablets and took them on a spoon to get it over and done with quickly. Wishing you well

J

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I agree Gnarli....when I was on Mtx everything had a metallic taste. It wasn't until I'd stopped taking the Mtx I realised my taste had returned to what I consider normal.

I didn't do anything about it as I was so well on Mtx I didn't want to rock the boat......but I was quite relieved when I had to stop Mtx my taste buds recovered.

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Yes it causes a metallic taste

Have gone off certain food and drink can't tolerate them now.

Also causes extreme fatigue and nausea too for a couple of days

Have Folic acid and loads of water

So don't know the answer

Rheumatologiat said I need to stay on it.

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Hello Zoppy89

I went over to self-injection Methotrexate from the tablets 15 mg once a week, with folic acid the other 6 days, along with Sulfasalazine (4 per day) and Hydroxychlorine (2 per day). This week has been a nightmare with a really concentrated metallic taste and coating on my teeth and gums all day, every day, although not quite so bad at night.

I am brushing my teeth 3 times a day, my teeth are stained, and today I am going to try the mouthwash my dentist said would help if I had mouth problems. I wanted to give this my best shot, in the hope that I might be able to reduce one or all of them in the future, but I am still in the early days (10 weeks since diagnosis) and my enthusiasm is waning.

I did wonder this week if the pollen starting to fly around was a contributory factor, as the feeling is like the whole taste thing is coming from my sinuses.

I eat a lot fruit to try to freshen my mouth, and yesterday thought I would try fresh pineapple - I would advise against it! It didn't seem to agree with me at all!

I will be phoning the Rheumatology Nurse this week, to see what she says.

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I reckoned the metallic taste was a price worth paying as I felt so well on Mtx. However, if I'd still had pain, swelling or nausea, I would have asked my rheumatologist for something different.

I find pineapple makes my mouth sore...even without Mtx! I relied on peppermints & salt water mouth rinsing.

Beware if the mouth wash you were recommended by your dentist was Cortisol...it turns your teeth brown.

Hope you get sorted,

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Oh dear yes it is called Cordysil or something like that - i will watch out for that as he said it was the only one I should use! Time will tell - there is also a deep cleaning toothpaste available .... more later

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I have a friend who has Gingavitis ...perfect teeth no fillings & she's 60+ but dreadful problems with her gums. Her dentist advised her to use it & he did warn her about discolouring her teeth. She decided she'd rather keep the disease at bay, but her teeth are getting discoloured.

I wonder if your rheumy nurse has any view on just using salt water for now,& seeing if the metallic taste fades. I did find after a few months I hardly noticed it. However I still find my teeth feel rough & I clean them far more than I used to & I stopped taking Mtx at least 5 years ago...so maybe it's just the RA & not Mtx at all?

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Thanks for that - I will ask the R Nurse when I phone.

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I have been on Metoject for two years, I did feel a bit sick at first, but still get headaches, I take folic acid tablets six days a week to counteract the symptoms and this really helps. Methotrexate is a nest drug but I would rather have it than all the pain from Flare ups. Good luck with it all.

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I had the bad taste, the nausea and the headache (mtx hangover) the whole time I was on the tablets and subsequently the pens. I couldn't find anything to relieve any of it, although I found eating ginger was warm and comforting on my tum when I felt really queasy. It may be that now you are on the pens you absorb more mtx so might need to have a lower dose to suit, if that makes sense, or maybe up the dose of folic acid. I was on 10mg Folic for 6 days a week when I was on mtx. If symptoms persist and become unbearable I would consult your rheumy again.

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I have just taken my second metoject injection and it was much better than the first. Much less 'hangover' and less fatigued, so hopefully this continues. My food tastes have changed, I really dislike tea and coffee which I drank copious amounts of before taking methotrexate (in tab and injectable form). Peppermint tea and water are good choices now, I hope you find something that suits you.

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Thank you all so much for taking the time to reply and share your experiences.

Lots of water i think for this week and generally slowing down a little bit whilst everything gets into my system

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Hi

I can't relate to the earthy taste you have noticed. But I do find that I crave chips for dinner the day after MTX day.

For nausea taking 5mg folic acid every morning with my breakfast helps hugely. Just not MTX day of course. I also find it is best to potter about the day after MTX day otherwise the nausea comes on big time and I feel very tired indeed.

The perfect solution I have found to stop the MTX headache is thanks to the folk on the forum. Up your water intake on MTX day. What works for me is 3 pints of water drunk from lunchtime onward stops it in its tracks. Nice to have a simple solution to a side effect for a change!

Joy

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I think it's trial and error with this drug .Folic acid everyday apart from MTX 8 day ,bicarbonate of soda and warm water better than any mouthwash for the mouth ulcers.Taking MTX8 at night helps although I do have a loose bowel day after and so fatigued that I can't do much but the nausea isn't as bad on metoject ,If it's persistent try lemon and ginger tea.As I said these remedies work for some and not for others .Won't hurt to try them zoppy😁good luck x

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Good luck with the injections Zoppy89 I couldn’t tolerate max orally- awful side effects. Been injecting now for some time, some of the side effects have gone completely and headache and nausea are minimal. Hope it works out for you xx

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I’m finding the nausea unbearable I inject Monday 25mg and then have to endure terrible Tuesday as I call it so I’ll try some of the hints and time re ginger- on a positive note terrible Tuesday is followed by wonderful Wednesday 👍hang on in there

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