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Methotrexate Oral Vs Injection

A myRAteam Member asked a question 💭
Wind Gap, PA

I’m anticipating that my rheum will prescribe methotrexate in the next month or so. I’ve heard lots of people have bad side effects to the pills and I already have IBS. My question is - has anyone ever started on injections without first trying pills? Or is it normal to have to try the pills first? I’m a nurse, not afraid of needles or giving myself an injection. Thanks!

August 7, 2020
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Answer Summary

Members shared their experiences with methotrexate for rheumatoid arthritis, with many confirming that starting directly on injections is... Read more

Members shared their experiences with methotrexate for rheumatoid arthritis, with many confirming that starting directly on injections is possible and often preferred, though insurance requirements sometimes mandate trying pills first due to cost considerations. Several members described practical strategies for managing side effects, including taking folic acid daily, splitting pill doses throughout the day with meals to reduce stomach upset, and timing doses for Friday or Saturday nights to sleep through discomfort. A recurring theme was that everyone responds differently to methotrexate, with some finding injections caused fewer gastrointestinal issues than pills, while others needed dose adjustments or switches to different medications entirely when methotrexate did not provide adequate relief.

A myRAteam Member

I was advised NOT to take all the pills at once but to take a few with a meal intermittently within 24 hours. So let's say 2 for breakfast, 2 for lunch, 2 for dinner (or whatever your dosage is) You can confirm with your pharmacist about this but when I took all the pills at once, I had GI issues and headache - this method works perfect and I barely even notice I'm taking any medication Good luck !

August 14, 2020
A myRAteam Member

I started on injections first. That's the only thing I've been on since I started then she add the pill plaquenil with it. But I have been doing the shot since January I have no problem giving myself the shot it is the side effects from the medicine it's self.

August 13, 2020
A myRAteam Member

I started on the injection first. So I only know of the injection. Terrible side effects. So I was put on folic acid to help with that. Have a good day.

August 8, 2020
A myRAteam Member

I just met with my Dr today. I have to be on methotrexate and folic acid.

August 7, 2020
A myRAteam Member

I started with injection

August 10, 2020

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