Why inject methotrexate for RA?
There are 3 main reasons that methotrexate injections may be used instead of oral tablets.
- Methotrexate side effects may be much less with injectable methotrexate.
- More methotrexate is absorbed with injections, so often it works better to fight RA.
- A higher dose can be administered with injectable methotrexate than is tolerable with oral methotrexate.
Is all methotrexate for RA the same?
There are major brands like Trexall or Rheumatrex, but methotrexate comes in generics as well. With a drug as old as methotrexate, the generics are considered virtually equivalent. However, using methotrexate from the same manufacturer each time is best.
Injectable methotrexate comes in cute little glass vials so you see its revolting yellow color. The bottles are different sizes. Some are intended for using a single time and then discarding. Larger bottles can be used several times. It’s much easier for RA hands to use the larger bottles.
What about preservative-free methotrexate
If a methotrexate vial is being reused, it ought to contain preservatives. The preservatives are added to prevent deterioration of the medicine or inhibit growth of bacteria or fungus. Preservatives are particularly necessary to maintain sterility of medicine intended for multiple use.
Pharmaceutical preservatives contain antioxidants or antimicrobials. The antioxidants may be familiar things like vitamin A or citric acid. There are also some synthetic preservatives. Methotrexate does come in a preservative-free form for those who have shown hypersensitivity to pharmaceutical preservatives.
My own injectable methotrexate prescription has been filled several different ways. I finally learned to inquire of the pharmacist each time. I just ask: “How many times am I intended to use this vial? Does this methotrexate contain preservatives?” Otherwise, it is possible to request exactly what I need in advance.
There have been times when all that was available were larger bottles in a preservative-free formula. Imagine how difficult it was for a thrifty girl like me to throw away almost full bottles because the pharmacist told me it was not safe for a second use.
Perhaps that sounds overly cautious. However, infection is the arch rival of an RA’er living on immune suppressing medicine. Preventative first aid, as I call it, is an art that we attempt to perfect.
Click here to read part 2 of Methotrexate Injections for Rheumatoid Arthritis: Needles.
- For much more information on methotrexate and RA
- Questions about Rheumatoid Arthritis blood tests
- Causes of Rheumatoid Arthritis: Are There New Clues?
- I failed this RA Control Quiz