Oral to injectable methotrexate

[catmom57]

I've been taking the maximum dose of oral methotrexate for about 6 months with almost zero pain relief. My doctor & I discussed switching to the injectable form as I had heard it was better in a lot of situations since it was better absorbed. I will pick up my first prescription in 2 days. So I'm curious if I will need to gradually decrease my oral dosage to the initial dosage of the injectable form? I'm thinking since I had to gradually build up the oral dose to be safe, I may have to decrease it for the same reason before starting the injectable form. I really wish I could just have my Prednisone back!!

[virtualreality]

Hi catmom57 , it's probably best to check this with your doctor in case there are any medical factors that affect your transition to the injections, but when I changed from tablets to injections I switched at the same dose (25mg weekly) - no tapering. It's the same medication, just a different form, but like you say some find the injections more effective. I hope it goes smoothly for you, and also that you start seeing some therapeutic effects very soon.

[Gottarelax]

If you're on the highest dose orally (I think 25mg) then a direct switch to the injection (probably also 25 mg?) is fine. I think the highest dose for injection is 30 mg. That's what I did. The consultant/nurse should talk you through it all though. I went for an appointment with the nurse to go through how to inject and took my first dose then. I was told to make sure I hadn't had an oral dose less than 5 days before so I'd be OK to inject and then switched there and then. I must say, there was a gradual improvement when I switched to injection. I can't say it's perfect but I can function a lot better and any aches and pains are tolerable. It was also better for my stomach.

[Boxerlady]

I just swapped straight over - sticking to the same day of the week as that worked well for me. I think that the initial titrating up is to help get your body used to it to help with possible side effects.

[Shana8]

I just switched over directly, also on highest dose and there were no problems at all. Actually I had fewer, almost none side effect with the injection compared to oral.

But - as others suggest: ask your doc for guidance to be sure. Best wishes

[Mall]

I just switched from tablets to the injection. It is the same drug. Don’t take tablets and take the injection, you’ll be taking too much of the drug. Once you receive a stock of injections get rid of your tablets, return the remaining ones to the chemist for disposal or put them in your injection disposal bin. Check this out with your nurse.

[Gaz227]

I’m on MTX injections so much better than orals , I wouldn’t wish for things like pred if you can get by without it , my adrenals have all but stopped functioning now due to pred and will be on it for life we no repreve unless they come up with another form of cortisol replacement drug . Good luck on your journey 🤞👍

[Itsapuppy]

Check with your doc but you don’t usually take oral and injection together but whatever happens you will be so pleased you made the change.

[Yellow-mellow1205]

I would ask my GP or rheumatologist or even your local pharmacist as it's pretty strong stuff, better to be safe than sorry xxx

[AgedCrone]

You will be given instructions as to how to tranfer over by your rheumy team. Don’t rely on your own guesswork.

[Runrig01]

you should be able to switch straight from one to the other. It is the same med, just a different route of administration.

I agree with Gaz227 re avoiding prednisolone. I have severe adrenal insufficiency due to long term steroids, for a condition where it was the only treatment. It was diagnosed when I had a severe stroke due to an adrenal crisis. 90% of my adrenals have atrophied and I need steroids for life now. I wake every morning with a flat battery, till my steroids kick in. I have to carry an emergency intramuscular steroid injection, which I or hubby have had to inject many times. Good or bad stress can send me on a downward spiral. So I urge everyone to use safer alternatives where possible, as AI impacts your life constantly, having to think ahead and dose for any stress you may endure.