Need Advice - Liquid Methotrexate

[vshorter]

I'm hoping someone can answer a couple of questions for me so I don't have to call the DR ofc or pharmacist and get a run around trying to explain my question. :mad: I'm betting that someone on the boards has run across this. :p

After DR visit yesterday I'm switching from Enbrel to Humira and from Arava to liquid Methotrexate. Brief history: started on MTX/Enbrel, couldn't handle MTX, switched to Imuran/Enbrel, then from Enbrel to Remicade, then from Imuran to Arava and off Remicade and back to Enbrel. And if you followed all that . . . you get a GOLD STAR (lol)!

Now, I'm not responding to anything, haven't in a while. Stopped work in Oct. filed for disability, continueing to decline - Doc wrote a script yesterday for a power wheelchair. But-back to the orginal question. The MTX script instructions says to "Inject 0.3CC once weekly, thereafter (with preservative) in glass of water or juice." I did not receive any syringes or brochures about where to inject, nor was there an inormation brochure. The other problem is the vial says "2ml Single Dose Vial / Preservative-free / Discard unused portion."

Any advice on how I am to take this? And does anyone else think that the pharmacy gave me the wrong medicine? I remember a year ago there was a problem getting the MTX with the preservative but I think my rhuemy would have known if that was still a problem. We are hoping I won't have the same problems with the liquid as I did with the pills since I can take a lower dose and get more out of it. Something has to start working - I'm running out of options! :eek:

Let me know what you all think - (Sorry for the book)

Thanks,
Vicki

[Ihurt]

I too have PA-severe most times, and I use the injectable MXT. I inject once weekly (.08 cc which is 20Mg). I inject on my thighs or on my fatty part of the belly (believe me I have alot of it too lol) I alternate sites weekly-this prevents one part from getting too sore.

After I prepare the needle in a sterile fashion, I draw up the solution from the vial. Then I prepare the site. Of course before all this starts handwashing is a must(sorry it's just the nurse in me).

I rub an alcohol swab really hard on the area I will be injecting. Remember the injection is "subcutaneous" which means under the skin. You don'tneed to inject downward into muscle, it just has to get under the skin. When the syringe is empty, hold a new alcohol swab over the tip before removing from your skin. Hold that in place to stop any bleeding. Bleeding should be very tiny and very little. Then bandaid.


The syringes should have been included with your RX unless someone forgot to write for them. A 25guage syringe is used for MXT-it's a small tipped needle., but a littletiny bigger than the one used for Enbrel which in most cases is a 27 gauge. Thge MXT vials come in 25 or 50 mg doses, and should be reusable. If the pharmacy gave you the wrong meds (which I don't think they did) it'sbecause there is a shortage on the liquid MXT. I buy mine from a company called IVP CARE. They are located in Texas. My insurance refuses to pay for the injectable and the pills left mevery ill so I pay from my own pocket, but it's not expensive at all! My vials (shipped in a set of two) cost me less than 8.00 when ordered.

Remember your folic acid 24 hours later! This is very important. Hope I answered your question. Good luck!

Elaine

[doodles]

Hi Vicky, I'm new here. I haven't even heard of liquid MTX. I've been on pill form MTX for three years and just discontinued use the first week of Jan. 06. My skin is going wild! I've had P for 45 years and PA for 15 years. I dicontinued because I don't want to thrash my liver and it stopped working for me. I want to try Enbrel but no insurance, so I'm looking into some kind of assistance. I do not know how all these people are affording these drugs, even with insurance!

My entire body is affected by this disease and I'm sooo sick of it.

Hope you find your answers!
Doodles

[RichJ]

hi doodles,
sorry to here that and i wish you the best and welcome to the p family. you will met some of the wonderful people on here and will find alot of great info. welcome and nice to meet you.

try have a good night all

richard

[doodles]

Thanks Rich! It's nice to be here. Have a good night!
Doodles

[vshorter]

Sorry to hear about your problems with no insurance. Even though my meds don't seem to be working right now, at least I have insurance so I can keep trying to find something.

You mentioned wanting to try Enbrel - have you contacted Amgen or Wyeth Pharmaceuticals? They're the ones that market Enbrel. The manufacturer is actually Immunex Corp. You might start by calling Enliven Services. It's a toll free number that is the support line for people who use Enbrel. 1-888-436-2735. They might be able to direct you to an assistance program. Or you could check out their website.
Enbrel (http://www.enbrel.com)
It couldn't hurt to check it out. Good luck, keep posting and let us know how you are doing.

Vicki

[fire]

Hi there all, beem comming to this site for about a year now just looking and reading all the post.I can"t type too save my life. lol" anyway I have had p & pa for 12 years now.Iam 47 now lost my job 5 years ago because of all the stuff that goes with this mad moster that likes too come out every once in a wile and raise it egulyhead.I found that liguid mxt is much easyer on belly as the pills have more liver affact that make some people feel sick for a day or so after.Iam on 20mg. once a week mxt with 50mg. Embrel 200mg.celbrex 40mg.celexa I seam to be so so rigth now but been a long road.Iam a man that has been there and done that.When i was working i would had all the people that have been there and done that. Iam on ssdi it took me two years too get it. I have been on so many differnt drugs over the years. Alot of them your body just will not take!!!! We just have to keep going until you fing something that works for you.But the stuff just dose not work over night it takes time 12 weeks or more to get it in to you.And it"s no fix it"s allways seems tobe lurking behine the next door you just wake up and you know he is with you again.Also blood test neet to be done once a month also need your folic acid every day (that to help you with your sick day after).And drink water lots of water day of and after. hope this helps some fire""""""

[ouchyk]

Vicki,

Can I have a gold star? :) I don't know anything about the liquid form of MTX I just wanted to wish you well on Humira with MTX. There are some new medications coming down the pike, they show promise and actually target a different part of our inflammation. Here is one.

http://www.clinicaltrials.gov/ct/gui/show/NCT00267956

Doodles, welcome, Sorry your pa's gone wild. here is a link for insurance help, I don't know a lot about any of the programs but I hope you can find something to help. Vicki's idea is a good one, go right to the source!

http://www.psoriasis.org/forum/showthread.php?t=12379


Fire, I wanted to welcome you too, please don't worry about any typing, grammer or spelling they don't count here, what you have to say does. I'm sorry you went thru such a hard time with SSDI...geesh. Like anyone of us wouldn't trade a pain free, well working body to work.. :confused: .


Karen

[Mybadgenes]

Vicki,

I have used MTX in pill form and injectible. Until I could no longer find the injectible that is and now it is back to pills. I never had to figure out the liquid amount as it was done in my derm's office by the nurse.

You have confused me with the instructions also. I hope you gave in and called someone. It makes me wonder if there is some MTX that you drink now as it says "mix with juice"?

Well, off to take my weekly MTX. Please, please let us know!!

Juanita

[luvwinnie]

Please call your pharmacist about this as soon as possible. Let us know what he/she says.

[vshorter]

Fire,

I am also 47. Glad you were finally able to get your SSDI. I am scheduled for a mental exam on Tues (my kids always said I was crazy :p ) and a physical exam on March 8th. A little nervous, but at least I know they are actively working my claim. I hope it doesn't take 2 yrs. I've also applied for disabilty thru my employer and haven't heard anything from them either - just hanging around broke (lol). Keep on posting - :)


Karen,

Thanks for the good thoughts - you get two gold stars! I had read about the reseach on that before and with my age and lack of response so far to Enbrel and Remicade, new drugs that work differently are certainitly of interest to me. I'm keeping my fingers crossed that Humira will be just different enough to work. ;) I'll even take 50%!

Juanita,

I had questioned the drinking part when I picked it up at the pharmacy, but they were really busy and the pharmacist just said "yes, you drink it." It still doesn't explain the inject part or how I measure and get it out of the vial - plus the perservative-free part. So, I have a call in to my doctor's office which may get returned today. Friday's are bad since they close at noon. I'll let you know what I find out.

Thanks all - have a nice pain free weekend :cool:
Vicki

[TheOne1313]

As far as insurance help goes, I would definitely contact Enbriel because the doctor was going to put me on that and if he did.....Enbriel was going to completely pay for the whole thing.

Im on Humira now which is 50 dollars a month.........its not too bad.

[JesseLou]

Vicki - I have never heard of drinking liquid MTX. As far as I can determine, it's meant to be injected subcutaneously, which is in the fat layer between skin and muscle. Meds that are meant for injection generally cannot be swallowed with the same results.

You need a fine guage needle ala the ones diabetics use for insulin, and you need a prescription to get them. The syringes have measurements on the side, and .03 is the same as 7.5mg in tablet form.

I think you need some more info from your doctor. Ask if he means for you to swallow the MTX, and for a demo injecting it.

[vshorter]

I talked to both the pharmacist (Marcie, the one I like was working today) and my doctor's office to get this clarified. :confused: The liquid MTX is supposed to be drank with water or juice so the instructions to inject was incorrect on the label - BUT I still need syringes to draw out and measure the liquid. Why the DR doesn't just have me inject, I don't know, since I thought that was the idea behind helping to reduce the stomach side-effects I had before (nausea) when taking pills (among all the other side-effects :( ).

Also, the MTX was supposed to have the preservative but the pharmacy only had the preservative-free and will look into getting the other. Pharmacist didn't think it would be a problem since I am not injecting it (less contamination risk) and she is going to fix me up with syringes for now. Guess I'll get a script later.

I'll try it this way for now and see how the side-effects are. I may have to call and ask the doctor why he wanted it drank instead of injected. I thought that seemed strange. :confused:

Thanks for all the replys everyone - I'd be interested in knowing if anyone else takes their MTX this way. The pharmacist didn't think it was odd at all so there must be others out there - or maybe it's just an Indiana thing :p LOL !

Vicki

[fire]

hi vicki No you don"t drink the stuff.I inject it with a short needle insulin syringe in the belly.Just grab a pinch of fat(don"t tell me you don"t you have none?)Make sure you clean it alcohol wipes good befor and after shot.The needle is 30 GAUGE 5/16"(8mm) real fine don"t even feel the needle go in.Also you have to have blood test done once a month.You can"t do that your self? I hat having to do that.(the blood test) it"s a paine in the arm!!!!! The doctors peolpe should have said nothing about drinking it!!!! That's why they call injectible.To get the stuff out of the bottle you just take that syringe pull the cap off the plonger pull back too 80cc air (make sure the top of bottle is clean with alcohol every time you reuse the bottle).and fill the bottle with the air.now pull the mxt too your dose.Mine is 80cc 20mg.Now get ready to stick it. bye for now fire

[Mybadgenes]

I still feel like there is too much controversy here. I VAGUELY REMEMBER
there being a reference to the drinkable kind so looked this up for you and it surprised me by saying there is a drinkable form to be mixed with fruit juice. WHO KNEW???? Here is the link.

http://www.psoriasis.org/treatment/psoriasis/systemics/methotrexate.php?PHPSESSID=13b80f08a3428d9ee9754b7 463d629cf

JUST MAKE SURE YOU HAVE THE DRINKABLE KIND IF THAT IS WHAT YOU HAVE BEEN PRESCRIBED. Talk to the doctor, PLEASE!!

Juanita

This is from THE NATIONAL PSORIASIS FOUNDATION

[vshorter]

Thanks for the link Juanita - it seems to be common in my area for people to drink the liquid form at least according to my pharmacist.

But I'd still like to get some input from everyone on a couple of things - I've been in such pain lately that I've got that real good "brain fog" going and you guys are great as a sounding board to help sort through things. :rolleyes: When DR and I talked about going back on MTX it was with the idea that it would be the injectable to reduce side-effects I couldn't handle before, that and the fact that I'm not working now and already fatigued, so what is a little more fatigue if it gets me walking at this point.

And just a note for Fire - I have no problem with injections (and unfortunately have no trouble finding enough to pinch). I do two a week already with Enbrel and already go every month for blood work. ;)

Question - what is the difference between swallowing MTX pills vs. liquid? It's still going to go through the same metobolic process isn't it? Won't I loose any benefit of going the liquid route? :confused: Am I missing something here?

I'm wondering if the nurses in typing up the script did something on the dosing part and I should call again on Monday and specifically tell them to check with the doctor on this.

What do you all think?

Thanks - it's just hard to think this all through when you can't think! :D

Vicki

[RichJ]

hi vicki No you don"t drink the stuff.I inject it with a short needle insulin syringe in the belly.Just grab a pinch of fat(don"t tell me you don"t you have none?)Make sure you clean it alcohol wipes good befor and after shot.The needle is 30 GAUGE 5/16"(8mm) real fine don"t even feel the needle go in.Also you have to have blood test done once a month.You can"t do that your self? I hat having to do that.(the blood test) it"s a paine in the arm!!!!! The doctors peolpe should have said nothing about drinking it!!!! That's why they call injectible.To get the stuff out of the bottle you just take that syringe pull the cap off the plonger pull back too 80cc air (make sure the top of bottle is clean with alcohol every time you reuse the bottle).and fill the bottle with the air.now pull the mxt too your dose.Mine is 80cc 20mg.Now get ready to stick it. bye for now fire
hi fire,
welcome to the p family. you will met some of the wonderful people on here and will find alot of great info. welcome and nice to meet you.

have a good night all

richard

[Mybadgenes]

Thanks for the link Juanita - it seems to be common in my area for people to drink the liquid form at least according to my pharmacist.

But I'd still like to get some input from everyone on a couple of things - I've been in such pain lately that I've got that real good "brain fog" going and you guys are great as a sounding board to help sort through things. :rolleyes: When DR and I talked about going back on MTX it was with the idea that it would be the injectable to reduce side-effects I couldn't handle before, that and the fact that I'm not working now and already fatigued, so what is a little more fatigue if it gets me walking at this point.

And just a note for Fire - I have no problem with injections (and unfortunately have no trouble finding enough to pinch). I do two a week already with Enbrel and already go every month for blood work. ;)

Question - what is the difference between swallowing MTX pills vs. liquid? It's still going to go through the same metobolic process isn't it? Won't I loose any benefit of going the liquid route? :confused: Am I missing something here?

I'm wondering if the nurses in typing up the script did something on the dosing part and I should call again on Monday and specifically tell them to check with the doctor on this.

What do you all think?

Thanks - it's just hard to think this all through when you can't think! :D

Vicki


I think that is a very wise thing to do.....wait til Monday and get it clear in your head.....(and mine too!! :confused: )

I agree....what is the difference between pills and liquid MTX to drink? It will do the same in the tummy if it does bother you. Thank goodness it has not bothered me this week.

I did so much better with side effects when I was on the injectible MTX. Had my shot, never gave it another thought and did away with nausea. If the injectible is available in your area I surely don't blame you for wanting it. You might could trade what you have been given for the injectible....that is AFTER you communicate with the doctor.

Good luck with it all....I know it is a strain on your nerves with all of this. I think you are on top of all of it now. :)

Juanita

[JesseLou]

If I were you, I would call and say I want to have the injectable MTX. Period.

Any MTX will give you some stomach problems, but the injectable should be less, and it will go away if you give it time.

Get some peppermint tea and doublemint gum. Both of these helped me a lot during the time when the MTX was bothering my stomach. They were better than nexium!