Doctor insights on:
Methotrexate Injections Vs Pills
Methotrexate injections and pills didn't work for scleritis and was wondering if remicade (infliximab) is good medicine for the scletitis?
Resistant scleritis: Initial therapy always requires systemic nsaids, glucocorticoids, or other immunosuppressives (rituximab & cyclophosphamide). Cyclosporine & mycophenolate may also work. Azathioprine or mtx may be most beneficial for maintenance. Tnf Alpha inhibitors (eg infliximab) may be effective in resistant disease. Scleritis should ideally be managed by ophthalmologist+rheumatologist experts. ...Read more
Methotrexate was originally used in the early 1950's as a treatment for cancer but was also found to be effective in many other diseases including rheumatoid arthritis and psoriasis. It has anti inflammatory and immunosuppressive properties which make it an excellent first line therapy for RA ...Read more
A mainstay for...: The treatment of rheumatoid arthritis and psoriatic arthritis, and other inflammatory conditions! I administer to my patients mtx by the subcutaneous route, thereby insuring 100% absorption and bypassing stomach and liver. When given with folic acid, I rarely see significant problems for my patients! ...Read more
Yes: Above 15 mg/wk, more effective (because of reduced GI absorption) and less GI side effects. ...Read more
Can I take the 8 pills of Methotrexate once a week or is it better to divide it and take it everyday one pill a day on the 7th day two pills?
Depends: Please talk to your doctor. I am an oncologist and am more familiar with weekly dosing (taken all at once, once per week), but please make sure that is what your doctor intended for your treatment. Thank you. ...Read more
In general what is the highest dose of methotrexate a child can be put on for jra? On 25mg weekly injections now and only 6 years old
Child weighs 53pounds what is the highest dose of methotrexate injections can be used for jra? She is already on 25mg injections weekly
6y/o has jra/jia and on 22.5 methotrexate injections for 3 months and lil improvement but rheumo won't add or change meds. What do I do?
Ask why not: Is your child's rheumatologist an adult or pediatric rheumatologist? Adult rheumatologists often are less aggressive with using tnf-inhibitors (enbrel/humira/remicade)because adults do get more infections with more aggressive treatment--almost all kids do not have this problem. Our group is very aggressive and we get great results-if rheum doc not willing to try Enbrel (etanercept) or humira, look for a new doc. ...Read more
Can going from 22.5mg of methotrexate injections to 25mg (in a 6year old) increase your chance of side effects? So if didn't have before can have now?
Yes, definitely: A weekly dose of 22.5mg of Methotrexate injections is already a pretty high dose for a 6yo child, so I would not go up further. I would reduce it to 12.5 or 15mg of Methotrexate weekly injections and add either Enbrel (etanercept) (less painful) or humira (equally effective and better for eye inflammation and ibd-related arthritis).Talk to your rheumatologist about it. Biologics are very safe with fewer side efx. ...Read more
Soap and water: Wash the injection area with mild soap and water, then wipe dry before injecting. ...Read more
What is standard dose of methotrexate injections in a 6 year old with jra/jia? She weighs 50 pounds
Discuss with doctor: There are many ways to effectively treat JIA with Methotrexate and biologics (Enbrel, Remicade, (infliximab) Humira, Orencia).Every doc has their own style and can work as long as the starting dose is titrated to work but not cause too many side effects. I would start a typical 50 lb 6yo with either 10 or 12.5mg of injected Methotrexate weekly but all kids are unique so your doc may start with a different dose ...Read more
Is it possible for hair to start falling out after being methotrexate for 3 months? Dose is 22.5 mg injections
Yes: Yes. This is a known, though uncommon problem with mtx. ...Read more
Can I take my methotrexate and humira (adalimumab) injections on the same day? Would it be better to split up?
Are there more risks or benefits with use of weekly methotrexate as injection vs oral for arthritis or ctds. Why is oral usually prescribed?
No: There is no increased risk in fact many believe the injectable form is better as it gets directly into bloodstream and does not depend on absorption from the gut. ...Read more
What is the highest dose of methotrexate injections can a (50lbs)6 year old be on when treating jra? She on 22.5mg for 3wks and no improvement yet
See your doctor: You need to speak to your child's doctor about her current state. He or she may want to change her regimen or the dose of her medication. ...Read more
I take methotrexate injections and been drinking daily for past 18 months and recently notice I itch all over after drinking, should I be concerned?
Yes: Since methotrexate is associated with liver toxicity, avoiding alcohol would be a prudent measures even if itching is not an issue. Regardless whether you are on methotrexate or note, if you itch from alcohol, the best approach is avoidance (alcohol is not in the pie chart). Be sure to get your liver checked out. ...Read more
Very high: Very high. Check that dose with the prescribing doctor before administering it. ...Read more
Is it better to be on 25mg methotrexate injections (53pounds) or lower dose of methotrexate along with a biological in treating juvenile arthritis?
JIA treatment option: There are 2 schools of thought. One is to be just on one medicine if you can if that controls the arthritis. If the arthritis is poorly controlled, than add a 2nd medicine. The other approach is to start with multiple medications to get the arthritis under control and then pull back later. Either approach is reasonable. I think many doctors try and just treat with one medication if possible. ...Read more
Is 22mg of methotrexate injections a high dose or just high for a 6 y/0 with jra to start off with? Please list possibly side effects at this dosage?
Toward high...: While there are variables-size and weight; severity of the condition- I start most adults on this dose and children 15-20mg. But one cannot really say. Certainly for the short term I would not expect issues. One question I would ask: did the medicine get started by a rheumatologist or pediatric rheumatologist! ...Read more
I think so: I don't think there is a drug interraction, duromine is a weight loss drug. It should not affect the methotrexate; it has likely done its job. That being said make sure the bhcg is going down and consider giving it a few more days out of precaution for the unknown, or use 1/2. There are no absolutes and giving it a couple more days won't hurt. ...Read more
Why is the injection site yellow after taking methotrexate? It looks like someone colored it with a high lighter
Bruise by injection: Bruise from injection may change color due to the breakdown of hemoglobin from red blood cells in extracellular space. Colors of a bruise are caused by sequential degradation of hemoglobin to biliverdin to bilirubin to hemosiderin, with hemoglobin itself producing red-blue color, biliverdin producing green color, bilirubin producing yellow color. ...Read more
Is it normal or unusual for me to have to sleep most of the next day after my methotrexate 15 mg injection? Day after that, the fatigue resolves.
What would happen if one took methotrexate injections weekly and their immune system was not overactive? Would they feel sick or have side effects?
Yes: In many patients yes in many patients know it is a liver toxin which causes fibrosis of the liver with long-term use. This has to be monitored all during the drug usage every six months. ...Read more
I take. 8 cc of methotrexate weekly. I had to stop injections for 3 weeks to have my thyroid removed. I started injections last week and have been sick ever since. Any problems if I stop shots?
Always check with: Prescribing doc before making changes in med regimen. S/he can discuss symptoms you're having & provide options for treatment. ...Read more
Folic acid need: Five mg per day should suffice.Get a more detailed answer ›
I would like to know if botox injections are safe since I have RA and take methotrexate and humira (adalimumab).Thank you?
Had a methotrexate injection yesterday after finding out there is still tissue left after a d&c was told not to take or eat food high in folic acid why is this?
Methotrexate toxic: Injection of methotrexate caused a raised bump under the skin and turned bright yellow? ANS; So your whole body is yellow or just the bump area. Need reason you are getting methotrexate at your age. If just around bump then most likely bruise going thru color changes as it resolves. Send pictures. I am here for next 3 hours. ...Read more
On methotrexate /weekly injections x 3months. In last week, waking up nightly very nauseated. Could increased liver enzymes cause nausea?
Had my methotrexate injection 7 weeks ago for an ectopic pregnancy (about 3 weeks along). Still getting pos. Home pregnancy tests. What's going on?
Should be tracked: After Methotrexate it is important that your BHCG levels be tracked all the way down to zero. Usually this is done weekly. This is done to make sure that Methotrexate worked to treat the ectopic pregnancy. Also since it has been 7 weeks are you sure that this is not a new pregnancy? It is possible that you are pregnant again. See an Obgyn for a BHCG blood test. ...Read more
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