Injectible MTX?

[SuzanneT]

Does the injectible form have intestinal issues like the oral form? I know for sure that I can't take the oral form, but I wonder about the injectible?
Sue

[ouchyk]

Sue,

I haven't done either form. I do have a friend, actually a few who do the injectible form and say it helps offset side effects.

KJ is one who does the injectable and JodyGk is another, I think they both found it helpful in this method of delivery.

Hopefully, they will see this and post!

Karen

[Mybadgenes]

Hi Suzanne,

I use the injectible simply for the very reason most do. That ole nausea. :eek: :eek: . In fact, tonight is my night! :) The reason I take it at night is I seem to do better with being asleep than blaming it on anything that might occur during the day such as a headache, etc. :rolleyes:

Mine is prescribed by my derm and I started out on pills but she is o.k. with the fact that I chose to switch to injectible form.

Some rheumys start people out on the injectible form....mine uses both.

Hope this helps....I had to learn to switch the dosage from pill form to liquid which is different but it is easy. The needle is minute. :)

Juanita

[SuzanneT]

Juanita, do you get nausea with the injectible? Or is that only with the oral? I'm wondering if it's as hard on your guts as the oral. I have microscopic colitis and can't take NSAID's or most anitibiotics. I don't mind the needle - I did my first Enbrel injection today and I was okay :). I know that there are benefits to combining the MTX with Enbrel, and also that PPPP responds well to MTX.

[JodyGK]

Hi, Suzanne, I'm on injectible MTX and have no gastrointestinal issues. There is also a theory that injected MTX may not have as many liver toxicity issues, and my rheum says she's seen anecdotal evidence of that. So I feel safer injecting rather than taking it orally. I'm happy to report I have had no side effects at all from injecting it, and I've been on it for over a year now.

Unfortunately, the manufacturer of MTX stopped making it in injectible form with preservative, and we never really got a straight answer as to why it stopped doing so. So it's not as easy as just having an RX written, filling it at any pharmacy, and you're off. What you need to do is see if there is a compounding pharmacy local to you. Then ask your doctor to prescribe it, and the compounding pharmacy can mix it up without preservative. What that means is each vial is "one use." You can only pull one dose out of the vial and then throw the vial away. So I get four vials a month, one for each week.

When you get the rx for the MTX, also make sure your doc writes an rx for insulin needles. They're very thin, even thinner than Enbrel needles, and quite easy to use. The needles are marked in CC's rather than mg's, so you need to ask your doc to show you exactly how much to draw into the needle to equal the amount of MTX you need. For instance, I'm on 20 mgs of MTX a week. The insulin needle has marks at 10, 20, 30, etc. I draw up to the 80 mark, and that equals my 20 mgs.

If you can't find a local compounding pharmacy, I can give you the name of my compounding pharmacy in Northern CA. I have them ship me my MTX for $8.00 each shipment. But you should be able to find one closer to you. Your doc probably knows of one.

Hope this helps, and if you have any other questions, I'll be happy to answer them the best I can. :)

Jody

[MikeK]

If you can't find a local compounding pharmacy, I can give you the name of my compounding pharmacy in Northern CA. I have them ship me my MTX for $8.00 each shipment. But you should be able to find one closer to you. Your doc probably knows of one.I was able to find a compounding pharmacy near me by using the "find a compounding pharmacist function" on the International Academy of Compounding Pharmacists website. Unfortunately, you have to register in order to use it. So far I haven't gotten any spam, which is always a concern. Here's a link to it: http://www.iacprx.org/site/PageServer?pagename=lookup_survey.

I hope this helps.

Mike

[SuzanneT]

Jody, thanks for the info:). I am definitely going to ask my derm. I don't know if Kaiser compounds, but there are a lot of compounding pharmacies near me. Come to think of it, I used to get a compounded MTX ointment that I used topically. So even if Kaiser doesn't do the compounding, MTX is cheap enough that I dont' mind paying for it myself. Do you need to get liver biopsies with the injectible form? I had to have liver function tests done frequently when I was on Soriatane, is that sufficient?

[JodyGK]

Well, I'll tell ya, every doctor is different in how much monitoring they require. My rheum doesn't require biopsies, she just monitors my bloodwork. But if I was getting my mtx from my derm, she would require biopsies once a certain level of mtx was reached. So I can't say what your doc will require, but I imagine at the very least you'll need periodic bloodwork done. I'm required to get my bloodwork done every month.

Hope it works out for you!

Jody

[JodyGK]

I was able to find a compounding pharmacy near me by using the "find a compounding pharmacist function" on the International Academy of Compounding Pharmacists website. Unfortunately, you have to register in order to use it. So far I haven't gotten any spam, which is always a concern. Here's a link to it: http://www.iacprx.org/site/PageServer?pagename=lookup_survey.

I hope this helps.

Mike

Thanks, Mike, this is excellent information to keep on file. I'm bookmarking for future reference. Living up to your rep as the Linkmeister, no surprise there! :D

Jody

[Mybadgenes]

Juanita, do you get nausea with the injectible? Or is that only with the oral? I'm wondering if it's as hard on your guts as the oral. I have microscopic colitis and can't take NSAID's or most anitibiotics. I don't mind the needle - I did my first Enbrel injection today and I was okay :). I know that there are benefits to combining the MTX with Enbrel, and also that PPPP responds well to MTX.

Hi Suzanne,

I will only add that I do not have any nausea with the injectible as I have no luck with NSAID'S either. I have no problem NOW getting my MTX in the injectible form as it is available here locally in Texas. I get it at my SAM'S pharmacy and can get needles of any size over the counter. Just call around and check and ask different pharmacies if they handle injectible MTX with preservatives.

I also, like Jody, could not get it for awhile and went back to pills but I am happily back on the injectible. I remember asking questions once and Jody came to my rescue explaining all of this. Thanks again, Jody.

I use 15 mg. per shot which transfers to 60 cc's and I also use an insulin needle which holds up to 100 cc's. Like I have said, I am used to needles also being a diabetic.

Isn't it great to be able to come here and ask questions?

Juanita

[JesseLou]

I have always used the injectable, and I did have nausea for awhile when I first started - but it was stomach only, and fairly easy to control, once I discovered peppermint tea. After awhile, my system got used to it.

I, too, have trouble with NSAIDs and aspirin.

[JodyGK]

I have always used the injectable, and I did have nausea for awhile when I first started - but it was stomach only, and fairly easy to control, once I discovered peppermint tea. After awhile, my system got used to it.

Ooh, peppermint tea...I always keep a supply of that onhand for any time my tummy's acting up for ANY reason! It never fails to calm down whatever's wrong, plus I love the taste!

Jody