Methotrexate

[Tompark]

I am on sulfasalazine currently which is working reasonably well however my rheumatologist has also mentioned possibly adding in methotrexate as well. Why do some people need to inject it and others take tablets?

[Marionfromhappydays]

For some people (which I am one) tablets upset my guts! Whereas the injection does not. Alot of people take the tablets with no problems so its an individual thing .

BTW I find the injection really easy

[MJSlide1958 in reply to Marionfromhappydays]

Hi Marionfromhappydays, which MTX injection do you use? because I have heard from my pharmacists that there are several types?

[Marionfromhappydays in reply to MJSlide1958]

Metoject pen 🖊

[MJSlide1958 in reply to Marionfromhappydays]

Thanks have noted this one is easy to inject

[Tompark]

Thank you I thought that might be the reason

[allanah in reply to Tompark]

As above!

[nomoreheels]

Mostly because MTX tablets are usually prescribed first. They are least expensive by comparison so if you're ok on them it makes sense. As an approximation tablets can be as little as £1.29 for 24 whereas injections (Metoject pen) start at £13.26 per pen for 10mg. However if side effects aren't tolerable or if like me an increase in dose causes an increase in side effects, or an increase in folic acid doesn't ease them that's when injections are offered. Any tum issues are often eased as the liquid goes straight into the bloodstream not through the tum meaning there’s greater bioavailability so sometimes you may find a reduction in dose works equally well. I've been on MTX 11 years, the first year tablets & ever since injections at various doses, 5mg folic acid 6 days.

I hope you find it helps with no issues. In common with other DMARDs you need to give it 12 weeks or so & you may find you need to get used to them but sometimes the more common side effects ease as your body gets used to them.

[Tompark in reply to nomoreheels]

Thanks that’s all really helpful.... I’m on sulfasalazine and my dose has just been increased to maximum so I may not need methotrexate anyway

[Summerrain14]

I do hope the increase in Sulphasalzine works for you. I had my Sulphasalzine increased fo six a day in April. However in July it became apparent we needed to add MTX. I started MTX tablets in August and just about to go over to the injections as my side effects of MTX have increased over the last month. I have been advised that having the injections will hopefully improve the efficiency of MTX for me too as currently still needing prednisolone at the moment too. I’m feeling optimistic going over to the injections as do think that the MTX has started to help a bit and hoping to be able to slowly taper my prednisolone again. All being well I will be having my training with MTX injections on the 19th Oct. 😊

[Tompark in reply to Summerrain14]

Thank you very much and I really hope that the MTX continues to improve for you. They do say that these drugs take up to 3 months to have the full effect. Fingers crossed for you.

[Knit12]

They start you on the tablets and if you have side effects they move you to injections. It was great for my joints unfortunately I was one of the few that had really bad side effects. Hope it works for you

[Gymcactus]

Hi I was diagnosed with RA at age of 67 after my husband passing away suddenly,never had problems before ,put on methotrexate , then sulphazalozine and tolerate them well so far. I guess I am one of the lucky ones,good doctors and excellent rheumatologist consultants in my area, am now in remission but still advised to keep taking meds.

[Moonbunny]

It can make some people feel sick, like I did and so they inject it so it can bypass the stomach....

[Boxerlady]

I was changed from tablets to injections because I needed a higher dose and more gets into your system via injection. I only had mild side effects with each dose increase (with both delivery methods) and they passed after a few weeks each time.

[Gillian15649]

I started on tablets and gradually increased dosage. Had No problems but as amount got very high I switched to injections because all of drug is absorbed that way and so can control it better. Easy and no problems for me. Years on am now on a biologic and a small amount of mtx. Still have injections but only because specialist says biologic works better with it. Have been in remission for years. Very stable. All damage done before RA was controlled.