MTX question

[Alias]

I have been using injectable methotrexate for nearly two years. I tolerate it well, experiencing only some mild nausea occasionally during the day or two after the weekly injection. My rheumatologist at the time of diagnosis said he preferred the injectable solution because it is more effective than oral. I know sometimes people are "upgraded" from oral to injectable if they aren't getting optimal results from the pills, or at least I think I've heard that. I'm wondering if anyone has gone the other direction, from injections to pills. I'm thinking of asking my doctor about making that change, partly because the insurance coverage would be better for the pills, and partly because the injections are slightly inconvenient. On the other hand my treatment has been effective and I don't want to jeopardize that by making a change. Has anyone out there made the change from injections to pills? If so did you note any changes in symptoms or different side effects.

[vdub]

Of those of us on mtx, I think the vast majority are on the oral version. I actually hadn't thought about injectable mtx before you mentioned it. Given most of us are on oral mtx, that probably speaks volumes as to its effectiveness.....

[jlove]

Hi Tom, I have some Methotrexate experience but I was in the pills to injections camp after the MTX pills stopped doing much for me. In my experience, the injections were more effective but they were not always very pleasant. I can see why you would think about switching to pills. You could talk with your doctor about whether or not it was a good idea and, like you said, keep in mind there is some risk involved in switching it up. It could be worth it for you, though, if it's safe and it would make you more comfortable with your treatment overall.

[annekat]

Me, too, have only used the pills, and have pretty much gotten used to the side effects. I had one moderate flare from being undermedicated and my MTX was increased to what has been said on here to be the minimum effective dose, 15mg once a week. Since then, I've had only one mild flare, a couple years ago, and that was resolved by increasing my pred for awhile. I haven't been issue-free, but have had no more WG flares since then. The issues I've had are like vertigo, double vision, hearing loss, things caused by the permanent damage inflicted by Wegs, and I don't think any change in meds would return any of them to normal at this point. The only other issue I've had was seasonal asthma last year, also not related to immunosuppressants, but treated with inhalers and a little extra pred. As far as I can tell, the oral MTX is keeping me on an even keel.

[me2]

I might guess that the same criteria and thinking that goes into a drug taper could be used for switching from injection to oral.