I hope this is temporary, but here in the US just recently there is a shortage of MTX. My doc just told me to start injectable. The pharmacy cannot fill the vials OR the pills! They will not tell me how long it will take. I have 1 week of pills.
as far as the injectables, My doc told me that it is impossible to get single dose injectables covered by insurance, and they are very expensive.
this shortage they say is due to the removal of one type of abortion pill from the market. MTX is used in high dose short term treatment for ectopic pregnancies, and there is a run on it. I will wait a week before I decide what my choices are. The MTX is helping for sure after 9 weeks. Had a few short lived flares but not one in my ankles or knees like before!
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BeachsideVia
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Hi, I’m so sorry to hear this especially when Mtx has been working for you. As I’m in the U.K. we haven’t had this problem here that I’m aware of as I’m prescribed the sub-cut Mtx pens. This is via our National Health Service though and not health insurance. I hope your Mtx is not paused and more Mtx can be manufactured/sourced and you get your supply in time. 🙏🏻💗
Sorry to hear this and hope it gets resolved soon. We've had all sorts of drug supply issues for various things in the UK - especially HRT. They are temporary but it's not much consolation when you need the medication.
Perhaps when the anti-women abortion laws start affecting men they will be more motivated to reverse them.
Can you get a steroid in the meantime to tide you over?
That's pretty shocking news, especially considering methotrexate is on the World Health Organisation's list of Essential Medicines! Like Neonkittie, I didn't realise the injectable version is expensive in the USA. I use that form myself because the tablets seriously upset my stomach (e.g. terrible acid reflux).
I thought that all patents on methotrexate expired long ago and so cheap generics are available, but that may not be the case in North America?
If I couldn't get MTX I'd probably be looking to switch to corticosteroids temporarily until supplies resume because they are the only treatment I know that work reliably and also quickly (although they are not recommended for long-term use). With other DMARDs it can take months to find out whether they're going to be effective for you, which can be a real trail!
I hope this problem is being treated as an emergency by your government, is resolved quickly and your own treatment is not disrupted. Good luck!
ripple effects of the shortage are being felt. My pharmacist is working to find it for me. The drug Ozempic is also in short supply. Those with type 2 diabetes need the medication, but many people are taking it for weight loss. I don’t know how serious the problem is, but I will find out.
I hope that this issue is soon resolved for you and everyone else who must be affected. The danger of unintended consequences of hasty legislation is clear
don’t know about shortages of mtx here in UK but each time I get my prescription for injections the pens are different. Sometimes an injector pen and other times an exsposed needle and plunger. Good thing I can manage to use both .
I can only sympathise with your difficult position. Not one I have ever experienced. I'm taking injectable MTX at 10 mg weekly - supplied on request from the hospital. There has been no mention of a shortage.
I also have no idea how much this medicine costss; but that isn't a problem in that the NHS supplies my needs.
Your supply is obviously dependent on private health insurance - something I also know nothing about. But it does make me realise that a health service funded by direct taxation, as here, is the best way of going about it. Insurance Companies are profiit making organisations with shareholders to satisfy. And shareholders like good bonuses!
Still, I do hope you manage to get your MTX before you run out. That's not a satisfactory position to find yourself in.
I hope this can be resolved, & soon especially as you find it is helping. It would be a shame to have to change to another DMARD due to a shortage. Or, maybe your Rheumy could prescribe prednisone until MTX is available?
It's made me wonder about dosage. Surely it would be 10mg tablets that would be used as an alternative if there was a shortage of injectable MTX (the usual administration for abortions)? As the dose is 1 mg per kg & the average weight of a woman is approx 72 kg (in the UK) surely 10 mg tablets would be given in the event of an injectable shortage? Just my musings, I don't doubt what you’ve been told is accurate, yet it the question why the dose of tablet used in rheumatology is also limited, unless there's such a rush on them all available stocks are depleted? It does seem most odd.
The cost of each when compared to the UK/Europe is vast, that I don't understand. I wouldn't think you only have the most expensive original licensed brands prescribed, do you not have cheaper generics available just as there are here? As well as the original licensed brand tablets (at £2.39 for 24) we have around 7 or 8 generic brands (from £1.29 for 24). With injectables though, my weekly Metoject pens cost to NHS are £15.25 each but there are 3 others available if need be, possibly slightly higher cost but not lots. I've had mine substituted a handful of times over the years. There are also pre filled syringes or even vials if things get desperate. Thinking back, when I lived in Spain we had a shortage of pre-filled syringes (before pens were available) & my Consultant arranged for me to have my injection done by the Rheumy nurse, from a large bottle. Could this be an option for you? Worth asking possibly. The prices I’ve given are costs to the NHS, usually in England we pay a cost per prescription of £9.65 (usually a month's supply) or less if you opt for a pre payment certificate for up to a year which is more economical, most do if they take multiple meds. There are exemptions though. I no longer pay as I’m over 60 for example, others apply. In Scotland, Wales & N Ireland prescriptions are free of charge to all. As I say, just my musings, I have time on my hands waiting for a blood test!
Again, I hope this is short lived & you're not without your MTX for long.
my Rheumy offered for me to get injections in his office. I was going to have a nurse friend teach me. She is certified in chemo. I want to try, just wait and see…. Have to get the vials, syringes still, and I will also inquire if this shortage will continue. Better for me to stay on pills right now if they are more available.
Thanks for posting this. I’m in the US, but feeling fortunate now that the tablets have always worked for me. The FDA has a drug shortage database one can search. It looks like it is just the vials for now. I hope it resolves quickly for you! accessdata.fda.gov/scripts/...
Just seen an article in a U.K. newspaper reporting a shortage because some MTX manufactured in India had been withdrawn due to contamination. So maybe the reduced supply is also having an effect.
ah I feel badly for my American neighbours to the south. I wonder if you could get it in Canada? No shortage here to my knowledge….I just got some recently at the pharmacy. $75 cdn for vials. Can’t recall how many boxes…no mention of shortage to me…
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