methotrexate by injection

[14penny]

Hi everyone, thought I would come on here to see if anyone has the same problem as I have changed from taking methotrexate by pill to injections and it is my third week have not noticed much difference but the day after I am feeling really sick and not very hungry wrists and hands hurting more than ever just wondered if this is what to expect and what else could I ask for for more relief as this is all making me feel really down.

[Amnesiac3637]

Hi. Sorry to hear you’re not doing too well on Methotrexate. I had the same problem some years ago. I changed from pill taking to the injections which made me feel sick at the thought of them every week. There’s something about Methotrexate ; rather like Marmite people either hate it or love it, though I think that’s a bit misleading as I’ve never heard anyone on here loving it! If it doesn’t suit you and it’s not making you feel well, which of course it should, ask to be prescribed something else. There’s plenty of kinder and faster acting drugs out there and there’s no need at all to stick to MTX just because that’s what the rheumatologist has probably doled out to many over the years and can’t be bothered to change his/her habits. It’s still seen as the ‘gold standard’ by some doctors but many are moving away from it. Your body, your decision. Do hope you feel better soon as feeling sick and painful for any length of time is the pits.

[14penny in reply to Amnesiac3637]

Thanks Amnesiac3637, lovely to hear your comments and I think I will try it for another couple of weeks until I see Rheumy and as you say see what else is on offer.

[AgedCrone in reply to Amnesiac3637]

One of the reasons Mtx is prescribed is because if a rheumatologist wants to move on from Dmards ....to qualify for biologics you have to have failed on 2 or 3 Dmards ...the number depends on the area health authority...one of which must be Mtx.

If it suits you it is in fact the gold standard drug is is often described as.

Unfortunately there doesn’t seem to be any way to know if it will suit you until you try it.

I had 7 very successful years on the tablets....it shouldn’t be dismissed too quickly....there are lot of much worse drugs out there.

[14penny in reply to AgedCrone]

Hi thanks for reply and when I was on the methotrexate tablets I did not get side effects only from the injections started three weeks ago I am thinking I should give it a lot longer to see if it benefits me

[Hidden]

14penny I suffered badly on the MTX pills so was switched to injection. I am a mixed person re MTX and awaiting consult in 2 weeks. I am on 20mg but I can only take it every 9 days not 7 days as I lose about 5days with side effects.

How long have you been on it as you need to give it 13 weeks minimum to kick in. For me I am getting better blood results but the side effects and constant flares they now think I need to add or change up my meds.

It has been 9 months for me of trial and error on it. However there are a lot of people who are doing really well on it too.

Keep talking to your RA team too.

[14penny in reply to Hidden]

Thanks Deeb2908 I have only been on injections for 3 weeks but hate sitting there with a bucket by my side. Looks like I am not giving it long enough so will try and persevere and hope it kicks in, it has made me feel better already for everyones kind replies Thanks again

[Boxerlady]

I'm one of the lucky ones as far as side effects go; only really had the foggy head/sleepiness problem other than initially having low mood/weepiness which went when I increased my folic acid to six days a week. The foggy head issue has always gone during the sixth week of a new dose (and when changing from tablets to injections) and after that I've felt fine. Joints-wise I'm not quite there yet - I'm about to add Sulfasalazine to my Methotrexate and Hydroxchloroquine - but when I had four weeks without Methotrexate things got much worse very quickly so it's definitely doing something for me.

Presumably you're on six days of folic acid; do you also eat well the day before your Methotrexate and drink as much as you can? It's hard to eat when nauseous but strangely, I find that it helps if I can eat something - toast, bananas, ginger biscuits work for me; also peppermint tea - or even just good old Polos.

[14penny in reply to Boxerlady]

Thanks Boxerlady its good to hear other opinions I did try to force myself to eat a small amount and felt a little better just sitting here with a bucket in case . But I think I will give it more time.

[Soundofmusic52]

I do great on mtx but had to give it 12 weeks to kick in also folic acid to stop the nausea we are all different it’s taken 2 half yrs to get me where I am today . If it wasn’t for people on here giving me hope I would of give up so hold in their hope you feel better soon 💐

[14penny in reply to Soundofmusic52]

Thanks for reply Soundofmusic52, it is good to hear opinions from everyone it makes you feel as if your not so alone and as I have switched from pills to injections it looks like I need to wait a little longer for it to kick in and not get these horrible side effects. Thanks again

[Llanberisman]

I switched seamlessly from mtx pills to injection about 6 months ago. Didn’t seem to be any loss of effectiveness. Still have the occasional flare-up, which appear to coincide with low air pressures. You’d probably be best advised by your rheumy team.

[14penny in reply to Llanberisman]

Thanks Llanberisman due to see rheumy in a couple of weeks

[Brushwork]

My experience is a little bit different. The Mtx pills made me really ill and for 3 days, until I eventually suffered depression, either caused by Mtx or due to the side effects. I refused to even contemplate a return to it.

Since then I have been on all the DMARDS and they either don't work or I have an allergic reaction to them. This was followed by 2 biologics - the first worked fine for a couple of weeks and then my body decided it would ignore it, it stopped having any effect, the second caused an allergic reaction. Then came the pandemic......

I was caught with a nasty flare and no effective meds. I didn't want to take steroids again, and was fearful of trying a new biologic and the Rheumy team agreed. So we decided to try Mtx injections - I had little hope. I feel really rubbish for the day after the injection and then I am ok. It is clearly having some effect on the RA but not enough as the flare in my left hand is persisting, only with Naproxen is it manageable....

What next?

[14penny in reply to Brushwork]

Thanks for reply and it does seem most suffer sickness the day after and I also am wary of biologics as when on Enbrel I managed to catch every bug/virus under the sun so dont want to chance getting Covid, think I will persevere with Methotrexate for another month and see what happens I wish you luck on finding what suits you|

[JEM95]

I love methotrexate - it took quite a while to work but has made a huge difference to me. When I was first diagnosed I couldn’t walk 100 metres, now I walk at least 5 miles a day and can manage ten or more 😀

I inject, but I do feel crap the next day or so.

Also, it made a difference when I went to folic acid 6 days a week, less yukkiness.

I have recently added in Benepali after 8 years of MXT as my RA wasn’t fully under control all the time.

MXT has given me my life back, but it took months to work properly.

Good luck x

[14penny in reply to JEM95]

Thanks for reply as with everyone elses comments it does seem to take a long time to kick in thanks and good luck.

[Cactiman]

Hi I switched from methotrexate tablets this Thursday so far I have had no side effects, although the aches and pains are still the same. It seems from other comments that it will take several months before I feel the effect and hopefully be pain free, if anyone does go pain free.

[14penny in reply to Cactiman]

Oh thats great you are coping well butif you do get sickness you will know that it seems very common untiil you have been taking it for about 10 or more weeks, good luck

[Knit12]

When I was on methotrexate injections I got anti sickness tablets from my doc which I could take when I felt bad. Unfortunately I developed other side effects that meant after 6 months I came off that drug

[14penny in reply to Knit12]

Oh that was bad luck being on it for so long what did you take instead of methotrexate? and I hope it worked for you

[Knit12 in reply to 14penny]

Unfortunately no the next one didn’t work no sickness though. On my third one though still early days x

[Tuppy66]

I changed from pills to injections a few years ago now as the pills made me so very sick to the point of actually vomiting, I now have methotrexate injections via a pen a lot less painful than actual syringes. However about 2 years ago I saw a locum rheumatologist who was concerned about a blip in my bloods so cut my injection dose in half within a week I was in a right state swelling, sore joints the works. For 18 months I was in agony until I had my dose increased again within a month I was much better. So it might be the dosage. I would also point out I take Humira alongside my Methotrexate and when the cheaper version became available Imraldi they changed me to that! I have to say that yet again that made me have a flare up as whatever is in the bio similar Imraldi it really didn’t agree with me so I had to fight to get the Humira back but when I did the relief was almost immediate. So it’s worth looking into if you take a combination therapy whether the the drugs are working together as sometimes they go out of sync. I hope you feel better soon.

[14penny in reply to Tuppy66]

Thanks for your reply I will give it a little longer to see if sickness passes and maybe rheumy will try something else it was strange as pills gave no side effects I only changed as my wrists and hand pain was getting so bad Hope your coping better now

[Angjoplin]

I was always fine with mtx until I had jak with them. Now it makes me sick as a pig for days. I've found plain salted crisps are the answer.

Got an appointment soon so I'm going to mention it.

[14penny in reply to Angjoplin]

thanks for reply, well I am going to get some plain salted crisps as I want to continue with Meth a little longer to see if I start to feel better on it. Good Luck

[mhlmom]

I can only tolerate 15mg injections. I feel washed out the next day for maybe 5 hours so I try to time the injection so the 5 hours slots into a time when I’m not doing much. I take it Saturday so I usually settle down in front of a movie Sunday afternoon and sleep it off. They tried me on 17.5 and 20mg but both made me wiped out for 5 days! I now have Rituximab infusions on top of the Methotrexate at 15mg wasn’t enough to stop the deterioration in my joints. I take folic acid Sunday to Friday.

[14penny in reply to mhlmom]

Good luck with all the ups and downs and I hope you feel better now I am just realizing how many are going through the very same thing|

[jbzm]

I moved to MTX injections (Metoject) last September when 20 mg of tablets were making me feel so rubbish that it was impossible to function. I didn't want to risk driving on certain days etc and the nausea was unrelenting.

I switched to 15 mg of Metoject as my Rheumy felt it works in much the same way as 20 mg of tablets. I finally moved up to 17.5 mg last night as my RA hasn't been under control since diagnosis. It was a case of increase the MTX or move to a biologic, both of which they were putting off due to Covid. In the end we've gone for the increase as the easier one to monitor for now so I've got regular bloods to look forward to as of this week.

I find the brain fog (for that read absolutely nothing useful going on in my head, rubbish word-retrieval etc) much the same as on tablets and the fatigue likewise, I feel like I've been driven over by a steam roller by about 9:30 am. I do remember a post on here about coffee and MTX, I just don't like the stuff but may need to do a bit of research on it!!

Initially I had no nausea at all on Metoject, amazing! However, I often do feel some nausea these days, but not to the extent as on the tablets. I find grazing, little and often on Saturday the best way forward. We make a bran loaf (not quite as dark as malt loaf) that always helps, without fail (none this week ), plain-ish biscuits like shortbread and I really can't even bear the thought of chocolate . . . probably a good thing. Home made ginger biscuits also hit the spot. Like many others, I also try to drink more than I would on a non-MTX day.

As to things hurting more. Yes, I do get that.i thought I was just being my usual slightly (!) bizarre self. Fingers are particularly stiff on a Saturday . . . just the way I metabolise it I suppose.

I trust the above makes sense. Really no brain cells by this point in the day.

[14penny in reply to jbzm]

Oh thanks for all your information really helpfull as I dont now feel so alone and will eat more {no appetite on sick days} but I think eating a little helps sick bucket at the ready ha ha|. I suppose I will find the right thing in the end it seems everyone is so different. Take care

[Tamtan2]

I was on mtx for 8 weeks then could not tolerate it or Alendronic acid Thought I was dying, been ofF them since April and feel better just on Prednisone 25 mg . Not for everyone but I’m doing ok I think except would love to rhuemy not seen anyone since March just nurse.

[14penny in reply to Tamtan2]

Hi we should all be seeing rheumy soon wearing face masks but telephone calls are what my rheumy is doing at the moment and got a face to face in September. Good Luck

[AgedCrone in reply to 14penny]

How much Folic Acid are you taking, have you varied when you take the Mtx & do you make sure you are always well hydrated.....it doesn’t help if you only glugg down liquid on Mtx day...you really do need to take in liquid regularly.

Do try to put the bucket out of your head......treat yourself to your favourite food.....& give it time...months I’m afraid rather than weeks.

It really is worth persevering, rather than changing a drug too soon.

Hope Mtx starts to work for you soon.