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Updated March 2021
(Brand names: Hospira, Methacord, Methotrexate Accord, Trexject)
This sheet is useful if your doctor has recommended injections of methotrexate either for better efficacy or to reduce side-effects. It gives information about how you, or a friend or family member, can safely inject methotrexate, the steps to follow and the equipment you will need. For general information on methotrexate, refer to the “Methotrexate” patient information.
The ARA have also developed a patient guide: Safe Disposal of Sharps - Information Leaflet. This patient leaflet outlines how to safely dispose of your methotrexate injection as well as highlighting links and locations where you can dispose of your sharps appropriately.
Injections of methotrexate are given once a week.
The injection is relatively painless as it uses a fine needle that is inserted just under the skin (subcutaneous). It is often described as the feeling of a slight pinprick and only lasts for a few seconds.
It does not need to be kept in the fridge but should be stored away from heat or light (in a cool pantry or cupboard, not on a windowsill). Ensure it is stored out of the reach of children.
If you are using the Trexject syringes you will need a sharps container for disposing of the syringe after the injection (The company for Trexject can also provide this or it can be obtained from pharmacies). You may also obtain alcohol swabs to clean the skin before injecting.
If using the vials as pictured below, you will also need Insulin syringes (1ml) which have a fine needle and are recommended for methotrexate injections. These syringes have numbers written along their side to help you draw up the correct amount of liquid for the dose of methotrexate you are taking. Syringes can be bought in bags of 10 at the pharmacy.
They can be bought in bags of 10 at the pharmacy. You should have a sharps container for disposing of the syringe after the injection; this can be obtained from pharmacies. You may also need alcohol swabs or cotton wool balls to clean the skin before injecting.
The following table tells you how much liquid to draw up for different doses and what number this is on an insulin syringe. Your doctor will usually prescribe a dose between 10 and 25mg. So, for example if your dose is 25mg of methotrexate you will need to draw up 1.0ml. 1.0ml is the number 100 on an insulin syringe.
If you are unsure about your dose or how much liquid you need to inject, check with your GP, pharmacist or rheumatologist before injecting.
This video shows how to inject methotrexate safely.
For further information on methotrexate ask your rheumatologist.