Methotrexate pill or injection ???

[Musiclady18]

Does anyone have any suggestions re: Methotrexate pills as opposed to injection??? I started methotrexate 3 weeks ago and all seems a bit better, but the last few days my stomach has been bothering me??? Rheumy says injection would ease that irritation of my stomach, any thoughts???

[PMRpro Ambassador]

My rheumy said to take half at night before bed and half the next morning and he found that that usually avoided the gastric effects. It certainly seemed to work for me. But the injection does usually do the same.

[Hidden]

Sometimes it’ll settle, l was nauseous with it, not at first but just suddenly after about three months, the sight n smell of food 🤢

I was offered injections but was thinking about the long term, so l stuck it out & it went as suddenly as it started.

How often do you take your Folic Acid as some Doctors recommend everyday EXCEPT MTX Day & that helps with the nausea.

MrsN

[Hobbitses]

I changed from pills to injections soon after being prescribed MTX because of slight tum discomfort. Probably worth waiting a while to see if your tum settles down (I would now be nervous of changing back to pills, but sometimes wonder if I should have given it a bit longer). I have no problems with the injections but pills are more convenient when it comes to holidays/flying/declarations of why you have to carry the MTX 'pens' with you as they can't go into the low temperature hold with the luggage...

[optimist-ok]

I took Methotrexate in pill form for 1yr. This was supposed to help in leaving steroids. I cannot comment on the injection form, I had no adverse effects stomach-wise but after a yr had a severe attack if shingles so was taken off Methotrexate. I have been on steroids for 9yrs, now on a maintenance dose of 5 mg a day. Hooe you find a comfortable solution. Best wishes

[optimist-ok]

Sorry for the 2 typo errors!

[Dobermanlover]

I am currently 2 months into a 3 month trial of the injections. Unlike the pills they have not affected my stomach, but haven't noticed any benefit from them. Sorry I can't be any more positive about the drug. Good luck.

[PMRpro Ambassador in reply to Dobermanlover]

Some say it takes longer, say 6 months, to feel the difference - and at least a year before it makes a significant difference to the pred dose.

[LizMitchell]

I have been taking methotrexate for 2 years now because I was struggling to reduce the Prednisolone, which I had been taking for 2 years since 2015, to below 10mg. It was suggested by Rheumatology that the initial MTX dose should be 15mg each week, but I agreed to 10mg only. Initially I took MTX weekly in tablet form, but at my request I changed to weekly Epipen injections as I did not want to subject my gut unnecessarily to any more long term medication. About 4 months ago I agreed to an increase of MTX to 12.5mg as I was still struggling to reduce the Prednisolone and am currently down to 5.5mg with low CRP and ESR inflammation markers!

I switched back to MTX tablet form for 6 weeks last Autumn, during a holiday abroad, as I didn't want the hassle of taking the Epipens with me, resuming injections when I returned home, and was not affected by the changes! Hope this helps.