Hi
I need to find out other peoples experience with mtx injections. I was on 15mg tablets then put on 10mg injection. consult now put the injection up to 15mg..ouch
mtx does not agree with me, causing oral effects, a higher mtx dose scares me, especially 30% extra.
please could other people share their experiences.
I am scared I am going to have to live on mtx which does not agree with me but RA consult not offering anything else.
many thanks
the injection should help oral side effects. 15mg is not that high, and quite often you adapt to it. How long have you tried it for?
I have been on 10mg injections for last 3 months, no improvement on oral problems, but 10mg injection not enough on it's own without hydroxychloroquine. so consult has upped 10mg injection to 15mg injection. mtx is causing the oral problems so they may get worse..
I was on 25mg mtx and switched to injections last year. Very easy to do and doesn’t affect my stomach as it used to.
Hi there, I found the MTX side effects decreased overall when I moved from tablets to injections (25mg with both), but I didn't have oral side effects with tablets as you have. Also found that the beneficial effects on RA symptoms improved. Saying that, if MTX doesn't agree with you, it's hard to understand why other first-line medications (like sulfasalazine or hydroxychloroquine) couldn't be considered for you, unless there's a reason they've been ruled out? Could it be worth asking the consultant or if you have one, the rheumatology nurse-led advice line? Wishing you luck with finding the right level / medication for you.
I've been on MTX since I was about 16/18 (dx. 1971 age 6). I initially took 25mg in tablet form but for the last 5-6 years have injected, currently on 17.5mg after asking to reduce from 20mg during Covid. Always taken MTX (over 40 years) apart from pausing for 2 pregnancies.
As others have commented, 15mg is not a very high dose. 25mg is usually the highest. How many weeks have you tried the injections for and have the symptoms you experienced with oral MTX diminished now?
I’ve been on MTX for 6yrs, and I’m fortunate I get no side effects. I started on 15mg then tapered up to 25mg. 15mg isn’t really a high dose, and I wouldn’t worry to much. It’s more important to get inflammation under control, as it’s not just joints it affects. I actually have AS which went undiagnosed for 25yr, as a result of years of uncontrolled inflammation, I now have heart and lung issues, which require further meds to manage. Most find side effects lessen with the injections, but if you’re finding them intolerable then speak with your team, as there are other options available. I am also on a biologic and steroids. I was also on Etoricoxib, an nsaid, but had to stop when I had a severe stroke at 52 as a result of an adrenal crisis. So now I use a pain patch to try and control my pains 🤗
Ah…..I see you are already on Mtx,..my previous reply was based on you just being offered it.
Try speaking to your rheumy nurse….she will explain how Mtx injections often work very differently from the tablets…but if you are set in your mind that Mtx is not for you……explain your reasoning & ask to be given another drug that your rheumy thinks may suit you.
Very often changing to injections works really well…so don’t miss the chance of getting settled on a drug that many people eventually settle on very well….I lived painfree on Mtx for 7 years…then it just stopped working…..but they were 7 very good years.
Tell the consultant you are not happy withe dose and want it reduced, with jabs you get the full dose, with tablets you don't due to absortion etc etc I'm not an expert but my consultant is, good luck.
Hi, no he won't reduce because my ra is not under control, but that's because I stopped hydroxy. so he is bumping up the mtx instead. the increased mtx dose might help the ra but the side effects will be worse.
Hi I started on the tablets which was 20mg then got put onto the injection so on 15mg did get put up to 20mg for a few months then went back down to 15mg which I have found I have less side effects I also take hydroxy.
But if you are not happy talk to the doctor. But it does take a little time to get working. Are you also taking folic acid? Was the hydroxy also giving you side effects because you said you stopped taking it?
no hydroxy is fine and my mtx doed not work without hydroxy, but the mtx is causing constant oral thrush and taking hydroxy means that I can't take flucanazole to get rid of the thrush, I also prefer mtx at lower dose to lessen side effects which I can't do without hydroxy
Oh okay I understand, well hopefully it gets better soon.
Hi I was prescribed 20mg methotrexate tablets and was on it for 6 months before I had to ask for help. The horrid taste in my mouth and constant nausea were making me miserable so now I have 17.5g injections once a week. I still get some nausea but the taste in my mouth is so much better. I do take extra folic acid though that my Doc prescribed. I don't like being on the drug but it's better than the pain. Good luck with the meds x
If you are having unacceptable side effects then make that absolutely clear to the consultant. There are other options. I ended up with azathioprine as my DMARD as I had considerable problems or allergic reactions to the others. Have a good study of the medicines available on the NRAS website so that you are well informed beforehand. Good luck!
ok thanks, are you on any other RA meds apart from azathioprine?
Hi Lindy Loo that isn’t a high dose, I take 22.5mg methotrexate injection. I am about 9 stone very slight and I have no side effects at all. I have tried to come off it but had such a bad time I realised how much my body needs the drug. It has given me my life back. I dread to think if I didn’t have methotrexate I would be in a very bad way. Chronic stiffness, constant pain in my hands and feet it is just a dreadful way to live.
If you’ve tried methotrexate for a reasonable length of time (at least 3 months) and the side effects are unbearable please speak to your rheumatologist and make it clear how you feel. Look at the NRAS website at the medication section. There are loads of other things you could try. I couldn’t tolerate methotrexate so was switched to Leflunomide with no side effects at all. Unfortunately I still didn’t get enough control so biologics were added.
What are the pros and cons of MTX injections as opposed to tablets?
Does anyone else get flares after MTX dose? 
Steriod Injection 
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