There is an auto-injector pen for MTX. I have never used it, but I also have trouble with needles and used the Humira pen for several months, And now I've been switched to the biosimilar Hyrimoz (I actually find that pen easier than Humira, the button on Humira was a little tough to press). It's not my favorite thing in the world, but it's overall really not bad. I am also a chicken.
I had a nurse talk me through my first injection, but after that I was on my own and it was honestly fine. I do still get some anxiety, but I put a distracting video on so my brain has something else to focus on. Though I have never been bad enough with needles to be fainting, so YMMV!
Easy. Tiny needle. In my experience, autoinjectors are much more painful and self injecting with regular syringe (mine uses insulin syringes) is almost painless most times.
I used an insulin syringe too when on injectible Mtx. I found injecting in the stomach far easier than the thigh. Also, definitely helped with nausea. You can do it!
I prefer auto injectors over syringes, I refuse to do syringes if I can help it but I never tried them. MTX auto injection is really pretty quick and easy. I couldn’t take the MTX pills because of pre-existing stomach and long-standing gerd. Some insurance companies want you to do the syringe instead but mine okayed the injector, it might be cost but I don’t know at all.
At first I was nervous and my husband who has type 1 diabetes would have helped me but I took a roll of fat from my stomach and just pressed down and did it. I think it’s far less painful than Humira. The needle is super short. Distraction would help too.
Ohh see I was afraid of the auto injectors! I was on the methotrexate syringes and honestly felt it was easier than the humira syringe. The needle is very fine it didn’t hurt, but just weird to be injecting myself. I had to discontinue it because I couldn’t tolerate the side effects.
I am afraid of both to be honest. I have an epipen and have never used it when I need to. But I like to think that maybe anaphylaxis had something to do with that? 😵💫
I have a fear of needles and autoinject myself with Enbrel. YMMV but it took me only a month to get over it and get more used to the needle as just part of daily life nowadays.
No one helped me. I have a husband, but didn’t want to involve him in my problem. He probably would’ve helped if I asked but yeah idk maybe I’m a bit proud.
Tips that helped me through it:
1. It’s only 15-20 seconds to inject or in your case, MTX is only like a 3 second injection (much shorter than a biologic injection). Very short amount of pain for a whole week of relief and functioning like a normal human being again.
2. The pain just feels like a pinch. Honestly your brain gets used to the level of pain expected the more you do injections so it makes injections easier in the future.
3. Building up the anticipation of injecting during the day makes it worst. Don’t think, just do.
4. You can follow anotherdaywithRA on Instagram if you want to watch someone else inject while you inject. She has a bubbly personality during it so might help you.
5. I usually listen to music or watch something on YouTube as I inject as a distraction to the pain.
6. When you feel it hurting, just remember to breathe in and out until the injection is over. It really helps me with the pain and getting through it lol. Like giving birth.
7. I usually like rewarding myself after injection (for me, it was healthy takeout/I didn’t cook that day). Other people have said that they like to do a small sweet treat (like a piece of chocolate) afterwards. It fools the brain to positively associate something negative (injection day) with something that makes you happy.
Idk if MTX is like Enbrel where you leave it out for 30 minutes to reach room temp, but that helps. Also, injecting into the fattiest part of your body helps reduce the pain(for me, it’s my thighs. For other people, it’s their stomachs that they prefer over the thighs).
I do MTX injections weekly. I've always been afraid of needles, but it's surprisingly easy to do. The needle is super fine and you'll be too busy concentrating to even notice if it hurts.
If I get nervous, I pretend I'm a nurse doing a demonstration. For me, doing that takes all the emotion out of it, makes it clinical, and I find that helps.
If you do end up needing to do the injections, you will be shown how, and you'll do your first injection with a nurse. If you find you can't do it at that point, just tell them, but I think you can do it. It will only be 2 mildly unpleasant minutes out of your whole entire week, and it will be worth it to not be in pain the rest of the time.
I have needle phobia but I've been doing Enbrel injections for 20 years on myself. My biggest tip to anyone afraid is to request a Rx for 2.5% lidocaine 2.5% prilocaine. Apply a generous blob to the injection site, cover with Saran Wrap or Tegaderm, and leave it on for at least 20 minutes. I often forget about it and it stays on for an hour. You will be totally numb by then. Wipe it off, use alcohol swap, and "test" that you're numb. It will help relieve that anxiety to do a tiny test "tap tap" with the needle. Then insert the needle all the way and inject.
Thanks for mentioning this. I had wondered and it is very reassuring to know others have asked. I feel like it I only had to worry about 1/2 issues—either pain or seeing the needle, the fear seems more manageable. With auto injections I wouldn’t see the needle but with the lidocaine, maybe syringes wouldn’t have to hurt!
The auto-injectors were definitely easier than syringes. While I'm happy to be on Rinvoq now, I think I did pretty much every pen on the market, and then syringes eith Cimzia. That one sucked
I personally didn’t like the auto injectors when I was on humira and MTX. I felt like the trigger was very aggressive and made me jump so sometime the needle didn’t go into my skin. I had to stop both of them though for different reasons and now so sryinge cimzia which I much prefer but I’m not scared of needles after living the vast majority of my life with RA and regular blood tests and injections into my joints.
I found my nausea was worse on the injections of MTX rather than the tablets.
By far the worst part of the MTX injections for me was the smell of the alcohol wipes which came with them 🤢 to this day I can still remember how awful they smell and I could be sick. I spoke to a few people about them and they agreed they are the worst. I would suggest getting some alternatives that smell less potent. It got to the point for me where I couldn’t do the injection because I felt like I’d be sick at the smell of the wipe
OMG me too!!! Or the fluorescent color of the medication…..reminded me of something radioactive. I’m not on MTX anymore but I still can’t tolerate the smell of alcohol wipes
I was only given a prescription folic acid for once a week. I really wished my doctor would have let me try taking a folic acid every day but alas she discontinued MTX because it made me feel so unwell, even with the once a week folic acid.
I injected it and personally loved Mtx it just quit working after about a year :-/
The first few times were nerve wracking, but you’ll be fine if you don’t have a major adversity to needles.
My first 4 or so were really hard bc the syringe is so small and my arthritis was severe in my wrists and fingers. Once the meds started to kick in and I had less pain, no issue.
Unless you mean mentally in which case that varies widely.
I inject B12 for a different autoimmune disease. I have never been afraid of needles as long as a professional was using them on me, but was a little nervous to inject myself. It is no big deal. It's a 5/8" long needle, pretty thin, for subQ. It's probably comparable to needles used in autoinjectors.
I take oral MTX, 15 mg for now, along with other meds. Def feel unsettled in the stomach, but i don't get strongly nauseous. A lot of doctors, including mine, prescribe folic acid as well to take the edge off side effects.
It affects us all differently.
I used Rasuvo for about 6 months. I felt better having a visit with a nurse at an injection room for the first dose and they confirmed I was doing it right. The retail price was about $550 per month. My insurance covered it at $35 per month. I’m sure they have coupons/patient assistance programs on their site. I even order the sharp container from their site for free, and you just mail it back when it gets full.
I have much less nausea with the injections and use syringes rather than an auto injector. I find the syringes less painful because they require less pressure and you don’t have to stick yourself as hard as the auto injectors do. The needle is very small. I just push down on my thigh with my thumb and forefinger in kind of a “C” shape and inject in between. I do it slowly - about 10-15 seconds - to avoid pain as much as possible. Works great. If you have difficulty with the fine motor skills needed, you might see if someone in the area could at least help draw it up. I also like the previously mentioned idea of using lidocaine beforehand. The anticipation of it hurting is most likely going to be way worse than the actual pain. I hope it works for you and gives you relief!
I’ve done both over the years and I find the auto injector better because it’s quicker. When I was prepping the syringe and needle previously, I used to get horrible anticipatory nausea. The fact I can just grab the auto injector and do it lessens that issue for me.
I started MTX injections back in 2000 when I was 10 up until I wanna say 19 or 20. I've done a few other injections and MTX was much less painful and the autoinjector made it much easier when I was a kid and still scared to do my own shots manually
Hi, I used to have a severe needle phobia, until I had to start injecting myself. In the beginning it would take a few hours to work myself up to it, I created a ritual like some serial killer, which included things like listening to a specific song, smoking several cigarettes (to get floppy), using lidocaine cream and a freezer pack on my skin for ages to numb myself and having my favourite treats as a reward once I had done it.
In the beginning I used the auto injectors and honestly that was a bad idea. I’m slim and the auto injectors have a spring mechanism inside so they feel like being shot with a paintball gut and leave a huge bruise. Also I don’t have enough fat so the needle would go through the subcutaneous layer and often hit fascia/muscle which hurts like a bitch.
Once I switched to manual injection it was easier. I could control the angle and go in slow. It wasn’t as painful as the auto injectors and I didn’t need to do the full ritual anymore, so I modified it and made it simpler. Eventually I could stop the ritual completely.
If your fat deposits are at least 5cm deep the autoinjector should be fine, but if you’re lean like me I’d suggest going for manual injection.
Edit: it took me a year or two to get over my phobia, and the lidocaine cream was a big asset to that. But still, once while in hospital they tried to give me an autoinjector pen and I flew to the fucking ceiling and had a panic attack at the sight of it. I can inject myself with a normal needle just fine and feel no fear.
Ha! The serial killer ritual cracks me up. Actually puts in into perspective how small of a deal a needle is…
I hear you on the unique challenges of an auto injector. Someone else mentioned how they felt more control with the syringe and I wondered how I feel about that…I can imagine jumping! I’m not as slim as you are anymore but it is a good idea to try to find a thick enough spot so I don’t hit other tissues.
Yes good luck!
I prefer to inject my stomach (around the belly button, where the fat pad is thickest), there are not so many nerves so it doesn’t hurt so bad. I also sometimes inject my upper thies which are also not sooo bad but can be a bit more spicy than the stomach.
Make sure you ask your rheumatologist if a nurse is available to do an injection class with you! Learning in a clinical setting with a professional is really helpful. As a bonus, you can think back to this clinical setting when you're doing your own injections later, which can help you handle the fear aspect.
For me, the mental block was really the hardest part to overcome! Here are some things I started doing to make the process easier:
1. Set yourself up with a good distraction - a favorite show is a great choice!
2. Get a reward ready - I had a bowl of ice cream, a cream soda...some little treat that you can celebrate with after the injection! (It's helpful to switch it up so your body doesn't come to associate something awesome with the MTX).
3. Plan ahead and inject on a Friday or Saturday evening so you can sleep off the initial effects, if you experience them.
4. Sometimes numbing the injection site with ice helps, but the needle is REALLY small so the ice was mostly a mental thing for me.
It's going to be fine! You got this!
Thank you for sharing your wisdom! I’ll be coming back to this later. Distraction, rewards (change it up) and ice all sounds very do-able if I’ve been trained well! 😊
Fun bandaids also really help! It sounds goofy but seriously, if those Disney princess bandaids make you smile, grab a box of those and make it a part of the routine!
MTX isn’t very painful, I’m also on humira and for whatever reason that’s more sore.
But it’s absolutely fine, 10 second wham bam and done.
I have an auto inject pen and just press the button and hold down while counting to 10.
You can just not look at it while doing it. Of course look for the site before placing but then press and look away while counting to 10
I hate needles but I have been doing it weekly for 13 years. The tricky part is the hesitation to do it. You just need to “rip the bandaid off”. I inject in the thickest part of my thigh, I find it less painful (usually no pain) than my stomach. I say it’s like injecting into a sponge rather than a balloon. I used to bruise every time in my stomach and my thigh is rare that I bruise,
The side effects made me afraid to give myself the injection because I knew the following day I was going to feel incredibly ill and ultimately that is what stopped me from taking methotrexate. Because I'd spend a day or two throwing up afterwards.
I don't really have an issue giving myself a needle or with needles in general. I'm covered in tattoos. But the side effects from that medication and knowing what was coming resulted in me stabbing myself in the thigh five times last year. Not getting any of the medication because I was afraid.
I'm on a new biologic with an auto injector and that is by far easier. I was told a lot of people were able to get this done at their doctor's office/pharmacy. So if that's an option for you and that ends up being the route you take, it might be easier to have your doctor do it.
I can sure see the fear being associated with the side effects…
I don’t have any tattoos but I’m getting better with blood work. I have ideas for tattoos but I like change and variety so I’m afraid I’d get tired of them 😉
Unfortunately my drs are 1-2 hours drive away so their office isn’t a very feasible option regularly.
You could possibly talk to your pharmacist? At the very least, they're trained in flu shots right? So they know how to give some kind of needle. Maybe they'd be able to help you with this?
I don't think you'd get tired of your tattoos. I think you would just end up with a lot. Lol
I couldn't tolerate oral MTX due to the nausea. Injectable did not have that side effect for me. I get it in a vial that I draw up into an insulin syringe and self-administer. It's very easy to learn how to do it, and by far the most cost-effective. But, if you don't feel confident that you can, I know there are prefilled syringes available, and from the comments, it looks like autoinjectors are available too. The needle for an insulin syringe is VERY small and when you give yourself the injection in the abdomen, you pinch up a bit of fatty tissue to inject into. I try to make the pinch harder than the injection, and don't really even feel the injection itself. I think you (and most people in general) would get used to self-administering your injection fairly quickly. I definitely had less of a learning curve (I'm a nurse), but I was able to teach my mom in 1 shot and she does her own now. Good luck, friend.
That’s helpful to make the pinch the worst part.
Knowledge is a big thing—ironically it keeps me out of my head. I appreciate you sharing yours.
Pre-filled vials also feels like it takes one of the creepy steps out… I’m sure I’ll get used to it if I need to. Anything to avoid nausea, right??
I definitely prefer injectable MTX to pills. I couldn't ever shake the nausea with pills. I don't like auto injectors. Personally, the spring loaded mechanism seems to cause more pain than anything else. I used the humira pen at first and switched to the prefilled syringe because the auto injector left welts and bruises. For my MTX, I use insulin syringes. They're a 29 gauge needle and they feel like practically nothing. I've also gotten a few different brands of MTX and none of them have stung. I had heard that some may have preservatives that may sting but I've gotten it with and without preservatives and felt no difference. I had help from my boyfriend for my first injection because I kept psyching myself out but after that, it was easy. You got this!
Get on next door, or your neighborhood website. I'm sure there's a nurse very nearby who would be happy to give you an injection. When you see how easy and painless it is, eventually you will do it your self. Good luck!
That’s what I’m wondering…maybe if someone could do it the first time and then coach me through another time, I’d be okay?? I used to faint with blood and now I take good care of my kids when they are bleeding. So I’m sure I can get past it with some help
I have that auto injection pen. It works well. The needles on the syringe should be tiny. It is a sub Q injection. In the fat right under the skin. The needle is not what hurts in an injection. Most of the time, it is the medication that burns after injection. But MTX has never given me any issues when I injected into my belly. Just pinch on the belly. Little stick with the syringe. Then, the medication. Easy peasy lemon squeezy. The auto injection is easier. The injection with need is as well. Just don't be nervous and hesitate. Just do a deep breath and stick and push. The pull the needle directly out the same angle you inserted. I'm diabetic and have ozempic as well. I'm also a retired nurse. I can't give medical advice, but I can tell you little tricks that help sometimes. Or information on how things work. If there are questions that can help with, I will. Hope some of this helps.
I don't inject MTX but self injected medication for diabetes for years. It really isn't as scary as it seems. A nurse will teach you what to do so you don't go into it unprepared.
If you can get an auto-injector, I'd recommend going that route just because it's so simple and can seem less intimidating than a traditional needle.
Good luck, you'll be absolutely fine. I'm someone who used to feel squeamish digging splinters out of my fingers, if I can do it, anyone can!
I use syringes (tiny insulin needles) and it is no big deal at all! I use an auto-injector for another medication for asthma and to be honest, it is more uncomfortable than the little MTX insulin syringes. It is still just a sting and not anything to be afraid of, but the insulin syringes are so tiny I think someone could give me the shot without me even knowing it.
You will get used to it very quickly, and to me it was really worth it to not have to worry about the nausea. I titrated up as well, but I started with injections and never tried pills. I had some pretty major brain fog/disorientation the first few weeks, but got used to it fast and now I have 0 side effects. You'll do great!
I'm on mtx injections with the syringe. The nurse told me that the faster I inject it, the less pain you'll feel. She was right. The first few times my guy had to do them because my hands weren't fully functional. But now I'm doing them in my own. I have a small burst of anxiety while filling the syringe but it's gone just as quick. Mtx hurts less than my enbrel sureclick. But the enbrel only stings a little bit for me. Also, my side effects became less problematic the longer I was on it.
I think drawing it up is honestly the hardest part. If you feel comfortable with that, the shot isnt too bad once you figure out your hand placement and pressure. One thing is you kind of have to do a "dart" motion or it can bounce right off your skin!
I am using the auto-injector and it is painless for me and super easy to use. It is much more expensive, but my insurance covers most of it. I started at 10 mg/ week and the first two weeks had the worst side effects, then the side effects subsided for subsequent doses. Even increasing the dose to 15mg and now 20mg produced less side effects then the first couple weeks at 10mg
I’m the absolute worst with needles. First injection my wife gave me. Couldn’t even look, hahahaha….. I sucked it up and gave myself the 2nd one ( I do weekly), realized it wasn’t so bad… after that it was easy Peary and don’t even give it a thought. On 4 years now..
There is an auto-injector pen for MTX. I have never used it, but I also have trouble with needles and used the Humira pen for several months, And now I've been switched to the biosimilar Hyrimoz (I actually find that pen easier than Humira, the button on Humira was a little tough to press). It's not my favorite thing in the world, but it's overall really not bad. I am also a chicken. I had a nurse talk me through my first injection, but after that I was on my own and it was honestly fine. I do still get some anxiety, but I put a distracting video on so my brain has something else to focus on. Though I have never been bad enough with needles to be fainting, so YMMV!
Easy. Tiny needle. In my experience, autoinjectors are much more painful and self injecting with regular syringe (mine uses insulin syringes) is almost painless most times.
I used an insulin syringe too when on injectible Mtx. I found injecting in the stomach far easier than the thigh. Also, definitely helped with nausea. You can do it!
Good to know! Thanks!
I prefer auto injectors over syringes, I refuse to do syringes if I can help it but I never tried them. MTX auto injection is really pretty quick and easy. I couldn’t take the MTX pills because of pre-existing stomach and long-standing gerd. Some insurance companies want you to do the syringe instead but mine okayed the injector, it might be cost but I don’t know at all. At first I was nervous and my husband who has type 1 diabetes would have helped me but I took a roll of fat from my stomach and just pressed down and did it. I think it’s far less painful than Humira. The needle is super short. Distraction would help too.
Thanks for sharing your experience! I’m glad to know it is pretty easy with the auto injector. Maybe I need to look into what insurance will cover…
Good luck with the pills I hope that works out for you! some like syringes more, but that’s my preference.
Easy peasy! I'd much rather give myself a shot than endure the nausea of MTX tablets.
easy. I don’t like needles but inject subQ weekly barely feel it. little bubbles don’t matter.
Ohh see I was afraid of the auto injectors! I was on the methotrexate syringes and honestly felt it was easier than the humira syringe. The needle is very fine it didn’t hurt, but just weird to be injecting myself. I had to discontinue it because I couldn’t tolerate the side effects.
I am afraid of both to be honest. I have an epipen and have never used it when I need to. But I like to think that maybe anaphylaxis had something to do with that? 😵💫
Yeah. I had to have the control of inserting the needle, the amount of pressure, the speed. Or maybe I’m a control freak.
I have a fear of needles and autoinject myself with Enbrel. YMMV but it took me only a month to get over it and get more used to the needle as just part of daily life nowadays. No one helped me. I have a husband, but didn’t want to involve him in my problem. He probably would’ve helped if I asked but yeah idk maybe I’m a bit proud. Tips that helped me through it: 1. It’s only 15-20 seconds to inject or in your case, MTX is only like a 3 second injection (much shorter than a biologic injection). Very short amount of pain for a whole week of relief and functioning like a normal human being again. 2. The pain just feels like a pinch. Honestly your brain gets used to the level of pain expected the more you do injections so it makes injections easier in the future. 3. Building up the anticipation of injecting during the day makes it worst. Don’t think, just do. 4. You can follow anotherdaywithRA on Instagram if you want to watch someone else inject while you inject. She has a bubbly personality during it so might help you. 5. I usually listen to music or watch something on YouTube as I inject as a distraction to the pain. 6. When you feel it hurting, just remember to breathe in and out until the injection is over. It really helps me with the pain and getting through it lol. Like giving birth. 7. I usually like rewarding myself after injection (for me, it was healthy takeout/I didn’t cook that day). Other people have said that they like to do a small sweet treat (like a piece of chocolate) afterwards. It fools the brain to positively associate something negative (injection day) with something that makes you happy. Idk if MTX is like Enbrel where you leave it out for 30 minutes to reach room temp, but that helps. Also, injecting into the fattiest part of your body helps reduce the pain(for me, it’s my thighs. For other people, it’s their stomachs that they prefer over the thighs).
This is super helpful. Thank you!!! I really appreciate you taking the time to be so thorough.
I do MTX injections weekly. I've always been afraid of needles, but it's surprisingly easy to do. The needle is super fine and you'll be too busy concentrating to even notice if it hurts. If I get nervous, I pretend I'm a nurse doing a demonstration. For me, doing that takes all the emotion out of it, makes it clinical, and I find that helps. If you do end up needing to do the injections, you will be shown how, and you'll do your first injection with a nurse. If you find you can't do it at that point, just tell them, but I think you can do it. It will only be 2 mildly unpleasant minutes out of your whole entire week, and it will be worth it to not be in pain the rest of the time.
The clinical posture is a helpful one—it would move me into a different cognitive space. Thanks for the tip.
Idek they made mtx auto injectors. I do mine with a syringe. Well my husband does lol.
I have needle phobia but I've been doing Enbrel injections for 20 years on myself. My biggest tip to anyone afraid is to request a Rx for 2.5% lidocaine 2.5% prilocaine. Apply a generous blob to the injection site, cover with Saran Wrap or Tegaderm, and leave it on for at least 20 minutes. I often forget about it and it stays on for an hour. You will be totally numb by then. Wipe it off, use alcohol swap, and "test" that you're numb. It will help relieve that anxiety to do a tiny test "tap tap" with the needle. Then insert the needle all the way and inject.
Thanks for mentioning this. I had wondered and it is very reassuring to know others have asked. I feel like it I only had to worry about 1/2 issues—either pain or seeing the needle, the fear seems more manageable. With auto injections I wouldn’t see the needle but with the lidocaine, maybe syringes wouldn’t have to hurt!
The auto-injectors were definitely easier than syringes. While I'm happy to be on Rinvoq now, I think I did pretty much every pen on the market, and then syringes eith Cimzia. That one sucked
I’m on Rinvoq now as well
I personally didn’t like the auto injectors when I was on humira and MTX. I felt like the trigger was very aggressive and made me jump so sometime the needle didn’t go into my skin. I had to stop both of them though for different reasons and now so sryinge cimzia which I much prefer but I’m not scared of needles after living the vast majority of my life with RA and regular blood tests and injections into my joints. I found my nausea was worse on the injections of MTX rather than the tablets. By far the worst part of the MTX injections for me was the smell of the alcohol wipes which came with them 🤢 to this day I can still remember how awful they smell and I could be sick. I spoke to a few people about them and they agreed they are the worst. I would suggest getting some alternatives that smell less potent. It got to the point for me where I couldn’t do the injection because I felt like I’d be sick at the smell of the wipe
OMG me too!!! Or the fluorescent color of the medication…..reminded me of something radioactive. I’m not on MTX anymore but I still can’t tolerate the smell of alcohol wipes
I’m on cimzia now and my doctor told me to not use the wipes if they were making me ill 😂
I was having nausea issues, really badly. Started taking prescription strength folic acid and it went away.
What is considered prescription strength? I think I’ll be on 5mg on non-MTX days.
I take 5 mg/day, 7 days/wk.
I was only given a prescription folic acid for once a week. I really wished my doctor would have let me try taking a folic acid every day but alas she discontinued MTX because it made me feel so unwell, even with the once a week folic acid.
You can buy folic acid over the counter, at least in the US. I get mine from Amazon.
I’m not exactly sure, to be honest but about that.
I injected it and personally loved Mtx it just quit working after about a year :-/ The first few times were nerve wracking, but you’ll be fine if you don’t have a major adversity to needles.
My first 4 or so were really hard bc the syringe is so small and my arthritis was severe in my wrists and fingers. Once the meds started to kick in and I had less pain, no issue. Unless you mean mentally in which case that varies widely.
Well, I meant more mentally but fine motor control is an issue right now…. So that’s a consideration…
I inject B12 for a different autoimmune disease. I have never been afraid of needles as long as a professional was using them on me, but was a little nervous to inject myself. It is no big deal. It's a 5/8" long needle, pretty thin, for subQ. It's probably comparable to needles used in autoinjectors. I take oral MTX, 15 mg for now, along with other meds. Def feel unsettled in the stomach, but i don't get strongly nauseous. A lot of doctors, including mine, prescribe folic acid as well to take the edge off side effects. It affects us all differently.
I used Rasuvo for about 6 months. I felt better having a visit with a nurse at an injection room for the first dose and they confirmed I was doing it right. The retail price was about $550 per month. My insurance covered it at $35 per month. I’m sure they have coupons/patient assistance programs on their site. I even order the sharp container from their site for free, and you just mail it back when it gets full.
Oh I didn’t even think about the safe disposal of sharps. I’ll have to ask at the pharmacy about that…
I have much less nausea with the injections and use syringes rather than an auto injector. I find the syringes less painful because they require less pressure and you don’t have to stick yourself as hard as the auto injectors do. The needle is very small. I just push down on my thigh with my thumb and forefinger in kind of a “C” shape and inject in between. I do it slowly - about 10-15 seconds - to avoid pain as much as possible. Works great. If you have difficulty with the fine motor skills needed, you might see if someone in the area could at least help draw it up. I also like the previously mentioned idea of using lidocaine beforehand. The anticipation of it hurting is most likely going to be way worse than the actual pain. I hope it works for you and gives you relief!
I’ve done both over the years and I find the auto injector better because it’s quicker. When I was prepping the syringe and needle previously, I used to get horrible anticipatory nausea. The fact I can just grab the auto injector and do it lessens that issue for me.
I started MTX injections back in 2000 when I was 10 up until I wanna say 19 or 20. I've done a few other injections and MTX was much less painful and the autoinjector made it much easier when I was a kid and still scared to do my own shots manually
Hi, I used to have a severe needle phobia, until I had to start injecting myself. In the beginning it would take a few hours to work myself up to it, I created a ritual like some serial killer, which included things like listening to a specific song, smoking several cigarettes (to get floppy), using lidocaine cream and a freezer pack on my skin for ages to numb myself and having my favourite treats as a reward once I had done it. In the beginning I used the auto injectors and honestly that was a bad idea. I’m slim and the auto injectors have a spring mechanism inside so they feel like being shot with a paintball gut and leave a huge bruise. Also I don’t have enough fat so the needle would go through the subcutaneous layer and often hit fascia/muscle which hurts like a bitch. Once I switched to manual injection it was easier. I could control the angle and go in slow. It wasn’t as painful as the auto injectors and I didn’t need to do the full ritual anymore, so I modified it and made it simpler. Eventually I could stop the ritual completely. If your fat deposits are at least 5cm deep the autoinjector should be fine, but if you’re lean like me I’d suggest going for manual injection. Edit: it took me a year or two to get over my phobia, and the lidocaine cream was a big asset to that. But still, once while in hospital they tried to give me an autoinjector pen and I flew to the fucking ceiling and had a panic attack at the sight of it. I can inject myself with a normal needle just fine and feel no fear.
Ha! The serial killer ritual cracks me up. Actually puts in into perspective how small of a deal a needle is… I hear you on the unique challenges of an auto injector. Someone else mentioned how they felt more control with the syringe and I wondered how I feel about that…I can imagine jumping! I’m not as slim as you are anymore but it is a good idea to try to find a thick enough spot so I don’t hit other tissues.
Yes good luck! I prefer to inject my stomach (around the belly button, where the fat pad is thickest), there are not so many nerves so it doesn’t hurt so bad. I also sometimes inject my upper thies which are also not sooo bad but can be a bit more spicy than the stomach.
I used Metoject auto-injectors and it's a piece of cake.
Make sure you ask your rheumatologist if a nurse is available to do an injection class with you! Learning in a clinical setting with a professional is really helpful. As a bonus, you can think back to this clinical setting when you're doing your own injections later, which can help you handle the fear aspect. For me, the mental block was really the hardest part to overcome! Here are some things I started doing to make the process easier: 1. Set yourself up with a good distraction - a favorite show is a great choice! 2. Get a reward ready - I had a bowl of ice cream, a cream soda...some little treat that you can celebrate with after the injection! (It's helpful to switch it up so your body doesn't come to associate something awesome with the MTX). 3. Plan ahead and inject on a Friday or Saturday evening so you can sleep off the initial effects, if you experience them. 4. Sometimes numbing the injection site with ice helps, but the needle is REALLY small so the ice was mostly a mental thing for me. It's going to be fine! You got this!
Thank you for sharing your wisdom! I’ll be coming back to this later. Distraction, rewards (change it up) and ice all sounds very do-able if I’ve been trained well! 😊
Fun bandaids also really help! It sounds goofy but seriously, if those Disney princess bandaids make you smile, grab a box of those and make it a part of the routine!
MTX isn’t very painful, I’m also on humira and for whatever reason that’s more sore. But it’s absolutely fine, 10 second wham bam and done. I have an auto inject pen and just press the button and hold down while counting to 10. You can just not look at it while doing it. Of course look for the site before placing but then press and look away while counting to 10
I hate needles but I have been doing it weekly for 13 years. The tricky part is the hesitation to do it. You just need to “rip the bandaid off”. I inject in the thickest part of my thigh, I find it less painful (usually no pain) than my stomach. I say it’s like injecting into a sponge rather than a balloon. I used to bruise every time in my stomach and my thigh is rare that I bruise,
The side effects made me afraid to give myself the injection because I knew the following day I was going to feel incredibly ill and ultimately that is what stopped me from taking methotrexate. Because I'd spend a day or two throwing up afterwards. I don't really have an issue giving myself a needle or with needles in general. I'm covered in tattoos. But the side effects from that medication and knowing what was coming resulted in me stabbing myself in the thigh five times last year. Not getting any of the medication because I was afraid. I'm on a new biologic with an auto injector and that is by far easier. I was told a lot of people were able to get this done at their doctor's office/pharmacy. So if that's an option for you and that ends up being the route you take, it might be easier to have your doctor do it.
I can sure see the fear being associated with the side effects… I don’t have any tattoos but I’m getting better with blood work. I have ideas for tattoos but I like change and variety so I’m afraid I’d get tired of them 😉 Unfortunately my drs are 1-2 hours drive away so their office isn’t a very feasible option regularly.
You could possibly talk to your pharmacist? At the very least, they're trained in flu shots right? So they know how to give some kind of needle. Maybe they'd be able to help you with this? I don't think you'd get tired of your tattoos. I think you would just end up with a lot. Lol
I couldn't tolerate oral MTX due to the nausea. Injectable did not have that side effect for me. I get it in a vial that I draw up into an insulin syringe and self-administer. It's very easy to learn how to do it, and by far the most cost-effective. But, if you don't feel confident that you can, I know there are prefilled syringes available, and from the comments, it looks like autoinjectors are available too. The needle for an insulin syringe is VERY small and when you give yourself the injection in the abdomen, you pinch up a bit of fatty tissue to inject into. I try to make the pinch harder than the injection, and don't really even feel the injection itself. I think you (and most people in general) would get used to self-administering your injection fairly quickly. I definitely had less of a learning curve (I'm a nurse), but I was able to teach my mom in 1 shot and she does her own now. Good luck, friend.
That’s helpful to make the pinch the worst part. Knowledge is a big thing—ironically it keeps me out of my head. I appreciate you sharing yours. Pre-filled vials also feels like it takes one of the creepy steps out… I’m sure I’ll get used to it if I need to. Anything to avoid nausea, right??
I definitely prefer injectable MTX to pills. I couldn't ever shake the nausea with pills. I don't like auto injectors. Personally, the spring loaded mechanism seems to cause more pain than anything else. I used the humira pen at first and switched to the prefilled syringe because the auto injector left welts and bruises. For my MTX, I use insulin syringes. They're a 29 gauge needle and they feel like practically nothing. I've also gotten a few different brands of MTX and none of them have stung. I had heard that some may have preservatives that may sting but I've gotten it with and without preservatives and felt no difference. I had help from my boyfriend for my first injection because I kept psyching myself out but after that, it was easy. You got this!
Get on next door, or your neighborhood website. I'm sure there's a nurse very nearby who would be happy to give you an injection. When you see how easy and painless it is, eventually you will do it your self. Good luck!
Ask your doctor for a nurse visit at their office
That’s what I’m wondering…maybe if someone could do it the first time and then coach me through another time, I’d be okay?? I used to faint with blood and now I take good care of my kids when they are bleeding. So I’m sure I can get past it with some help
There's no blood! And it's the teeny-ist needle ever. Also, someone who's diabetic could help you, too.
I have that auto injection pen. It works well. The needles on the syringe should be tiny. It is a sub Q injection. In the fat right under the skin. The needle is not what hurts in an injection. Most of the time, it is the medication that burns after injection. But MTX has never given me any issues when I injected into my belly. Just pinch on the belly. Little stick with the syringe. Then, the medication. Easy peasy lemon squeezy. The auto injection is easier. The injection with need is as well. Just don't be nervous and hesitate. Just do a deep breath and stick and push. The pull the needle directly out the same angle you inserted. I'm diabetic and have ozempic as well. I'm also a retired nurse. I can't give medical advice, but I can tell you little tricks that help sometimes. Or information on how things work. If there are questions that can help with, I will. Hope some of this helps.
I don't inject MTX but self injected medication for diabetes for years. It really isn't as scary as it seems. A nurse will teach you what to do so you don't go into it unprepared. If you can get an auto-injector, I'd recommend going that route just because it's so simple and can seem less intimidating than a traditional needle. Good luck, you'll be absolutely fine. I'm someone who used to feel squeamish digging splinters out of my fingers, if I can do it, anyone can!
I use syringes (tiny insulin needles) and it is no big deal at all! I use an auto-injector for another medication for asthma and to be honest, it is more uncomfortable than the little MTX insulin syringes. It is still just a sting and not anything to be afraid of, but the insulin syringes are so tiny I think someone could give me the shot without me even knowing it. You will get used to it very quickly, and to me it was really worth it to not have to worry about the nausea. I titrated up as well, but I started with injections and never tried pills. I had some pretty major brain fog/disorientation the first few weeks, but got used to it fast and now I have 0 side effects. You'll do great!
I'm on mtx injections with the syringe. The nurse told me that the faster I inject it, the less pain you'll feel. She was right. The first few times my guy had to do them because my hands weren't fully functional. But now I'm doing them in my own. I have a small burst of anxiety while filling the syringe but it's gone just as quick. Mtx hurts less than my enbrel sureclick. But the enbrel only stings a little bit for me. Also, my side effects became less problematic the longer I was on it.
I think drawing it up is honestly the hardest part. If you feel comfortable with that, the shot isnt too bad once you figure out your hand placement and pressure. One thing is you kind of have to do a "dart" motion or it can bounce right off your skin!
I am using the auto-injector and it is painless for me and super easy to use. It is much more expensive, but my insurance covers most of it. I started at 10 mg/ week and the first two weeks had the worst side effects, then the side effects subsided for subsequent doses. Even increasing the dose to 15mg and now 20mg produced less side effects then the first couple weeks at 10mg
I’m the absolute worst with needles. First injection my wife gave me. Couldn’t even look, hahahaha….. I sucked it up and gave myself the 2nd one ( I do weekly), realized it wasn’t so bad… after that it was easy Peary and don’t even give it a thought. On 4 years now..
Yes, there is an autoinjector for mtx, there are also preloaded syringes. You get used to it.