I have been doing some reading. Saw my consultant this week and I’m going to be put onto methotrexate. It’s a fact of life that I am sadly recently widowed, my family live down in Hampshire I live in Cheshire. Though I have really good friends around me my concern is with the tablets if I have a problem with them I have no physical support. So my question is can I ask to go straight onto the injections rather the risk of side effects of the tablets in lockdown and being on my own trying to deal with that.
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Wraf22
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I’m so sorry your in this situation . I think it’s best to contact your rheumatologist and explain everything. Ultimately it will be his decision. Tablets are generally first point of call as they are cheaper and if they are causing problems or not working effectively then it is injections. Worth a try contacting him.
Sorry to hear of your loss. I would imagine your consultant should be the best placed to answer your question. One issue would be dosage...it’s easier to get the dose right using the tablets. I had no side effects to tablets, by the way, and only asked to go onto injection after a year or so.
I'd say that the advantage of starting on tablets is that it's easy to tweak the dose and you'll be able to start on them right away. With injections, you may need to wait for a training session and then wait for a new prescription every time you need to change dose.
I started on tablets and only changed over to injections when my rheumy wanted me on the highest dose (apparently more gets into your system via injection); I only had mild side effects which went after a couple of weeks on each new dose.
Have you got a rheumy nurse? In my clinic they're more "hands on" than the consultant and very helpful when I ring them.
So sorry for your loss, my mum lost her husband in May x
I started on the tablets but they didn't agree with me, I had a few days of feeling very nauseous, achey tummy and couldn't eat anything, it wasn't very nice but nothing that I couldn't have coped with by myself.
I would stock up on some nice drinks and soup or something easy to eat just in case, alot of people have no problems with it.
I started on the injections now, had a few issues and being put on a reduced dose but I've got to wait for a new prescription from consultant and its all quite slow. Injections are really easy though.
After only 3 weeks the mtx started working though and it was awesome !
Good luck and please let us know how you get on, this forum is amazing so is the NRAS helpline x
I started methotrexate just before the first(!) lockdown, and as I also live alone, like you I was a little concerned as to how I would cope but I actually found the hardest part of taking the tablets was plucking up the courage to take them in the first place!
Yes I do find I usually feel a bit "meh" the day after but certainly nothing that a nap or a few hours with a cuppa and daytime tv couldn't solve... and although there are times when it would definitely be nice to have someone around for support, in some ways it's quite nice just to be able to please myself and take things at my own pace.
Certainly some people do struggle with the side effects of the tablets (and some struggle with the injections too) but I know there are also many like myself who manage pretty well and find it's a small price to pay for the relief they eventually bring.
Obviously it's up to you and your rheumy, but as others have said above, there are pros and cons with the injections too, so if you do decide to opt for the tablets initially, with any luck you should hopefully find they're really not too much of a problem.
Wishing you all the best of luck whatever you decide... x
Hi Wraf. I'm so sorry to hear about your husband, that really is very sad.
I have the MTX injection and have done from the start as I have a very sensitive stomach and the rheumy doctor thought it better to go straight onto the injections so I can't comment on the tablets. I initially did get some nausea and headaches but that settled in no time at all, as the doctor also put me on Folic Acid. I hope you get on with whichever type you are given and that you don't experience any bad side effects. Good luck. x
Sorry for your loss I take 20mg and my advice was to space dose so take four tablets in morning after food and four at bed time I also take folic acid every day except methotrexate day. Good luck 🤞
I was diagnosed in August so I asked to go straight onto the injections as I was concerned about the nausea that the tablets sometimes cause. I was put straight onto the injections and touch wood I’ve had no problems yet.
I started on tablets then after a couple of years went on to a lower dose by injection. If you can start on the tablets it ensures they can get you on the right dose
This is a really difficult situation to be in and I'm hopeful that your consultant is supportive of your choice.
Tablets are cheaper however the injection is better from a side effect perspective and a medicine absorption point of view. I would push for that if it were me. .often they don't want to start you on Metoject for cost but also it's easier to manoeuvre doesage with tablets as you are getting used to this.
My advice and what helped me when I was on the tablets was asking for an antiemetic and to have the maximum does of folic acid as this helps counter act the nausea.
You may be okay on the tablets, everyone is different. If your side effects are too tricky to manage then it's definitely worth contacting your consultant in the interim between your appointments.
I hope that's helpful, remember it's all about quality of life and if the side effects are to hard to manage then they need to support your choice of medication.
I have also been told I need to go on MTX I have held out for so long and my condition has deteriorated , as listening to the comments on this thread I think I am ready to give it a go , my consultant said he would put me straight on the injections as I have had a lot of stomach issues with pred over the years and can’t handle the prazol group of anti acids , always used gastro resistant pred which works ok for me . Good luck and fingers crossed you get relief and a better quality of life all round 👍😀
Lots of advice already! I have always been on tablets (for last ten years) with no real problems and wouldn't want the complication of injections unless there was a specific reason.
(The methotrexate has worked - little change for first three months then steady improvement in the RA symptoms over the next year until I was really back to normal).
You will be started off on a low dose with regular blood tests to make sure that the methotrexate is not causing liver or other problems. The dose will then be stepped up until it is sufficiently high to bring the RA under control. This is probably easier with tablets as the standard prescription is a number of small 2.5 mg tablets - I am on eight once per week for a total of 20 mg.
Personally, I have always taken the tablets one at a time while eating my breakfast so that they go into my stomach mixed up with food. Some people say take them at night but I would rather be up and moving around to ensure that they go through my digestive system.
Side effects? As I say, nothing serious. Sometimes I feel a bit tired or slightly queasy on the afternoon of the day that I take the pills. Certainly nothing as bad as having active RA!
Some people do have real problems but the same applies to other RA drugs. It is very important that the blood tests get done lockdown or no lockdown. I was initially on Sulfasalazine. This fixed the RA but put my liver function results way out of the safe range. If any problems emerge then you will either be told to stop the pills or reduce the dose.
I'm on the tablets. I started at 10 mg - 4 pills - and I take them after dinner on Friday night. That way if I'm going to feel unwell, I can go to bed, and I don't have anything I have to do the next day. The first couple of weeks I had some nausea and fatigue the next day, but that seems to have stopped, and I am up to 15 mg without a problem.
Make sure you take the folic acid you will be prescribed every day, as it helps to avoid side effects. I was also concerned about starting methotrexate as I have a sensitive stomach with terrible GERD for many years, but it has turned out not to be a problem. All I can say is that I wish it would start working faster, but it has only been a few weeks.
I hope you and your doctor figure out the best plan for you and that you have an easy time with it.
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