Switching from MTX oral to injection

[ScreaminMeanie]

Any tips? Has anyone else done this and experienced worse/different side effects than from taking it orally?

I still have to overcome my phobia of needles so that I can inject myself, but hubby (w/years as a paramedic) is my fallback shot-giver. My rheumy's nurse gave me a "lesson" today and gave me the first injection. I was surprised at how little it hurt. Knowing that may make it possible for me to do it myself, but I won't know for sure until it's time for my dose next week.

[purr6]

Hi,
I switched from mtx oral to injection due to the fact that I was experiencing extreme nausea and vomitting. I was elated the first week as I experienced no side effects after the first injection. The second week, however brought some mild nausea and then things got worse with the next few injections. I now have switched to Immuran and have been very lucky to feel almost no side effects. I think each person responds differently to each medication, so my experience may not be yours. The actual injection itself was very tolerable I found. The pain of the actual needle was not really an issue.

I hope the mtx injection works for you without any difficulties.

Michele

[pwc51]

I have switched from oral to injection. Far more tolerable. I hated the oral with a passion -- made me feel rotten for a day every week! A couple of lessons on self injection and I am now going solo - no real problems so far, but it is early days yet.

[ScreaminMeanie]

Luckily I wasn't having any bad side effects from the oral mtx. It just stopped working. I was already close to the max oral dosage, so doc suggested trying the injectable. Keeping my fingers crossed for it working for both of us, pwc!

[Chris G]

I switched from oral to injectable 2 weeks ago. I was at 30 mg oral, and not experiencing nausea, but had bad "mental" side effects - drunken or drugged feeling that I couldn't shake - it also made me very agitated. So far, I have not experienced these side effects with the injections. The shots themselves are not bad at all. Be brave! You can do it yourself too!

[ScreaminMeanie]

Chris and pwc, how long were you on oral before you switched? I started the oral last early July.

[Chris G]

I was on oral since last November. Did you switch because of side effects? Or because the mtx was not working well enough? What was your oral dose?

[ScreaminMeanie]

I was taking 20 mg orally, then I started having pretty severe inflammatory arthritis in my ankles. We bumped my pred up a tiny bit, and that didn't do the trick, so it was either increase the mtx or switch to imuran or cellcept. I kind of wanted to stay on mtx since I've been having so little in the way of side effects. She felt like increasing the mtx dose orally would be a waste of time due to absorption issues, so she switched me to the injectable and bumped me up to 25 mg.

[Chris G]

Mtx alone is not working for me. We are adding imuran to the mix. But I'm still holding out hope that because the injectible mtx is better absorbed, it will start working soon. Maybe I'll see some improvement in the next couple of weeks - that's what I keep telling myself to keep from getting too discouraged - because even after we add the imuran, it will probably be a couple months before we know if that will work.

I hope you see relief soon. Please keep us posted!

[ScreaminMeanie]

Likewise, Chris!

I forgot, adding another drug was one of my options, too. Since I don't have organ involvement, it's going to be hard to justify rtx unless/until we know that none of the other drugs will work. So, what started out as "3 months on pred, then taper off + one year on mtx" is now turning into who knows what. Oh well, if I even feel less tired on the injectable mtx, I'll consider that a win!