Methotrexate chat.

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dodie74

dodie74

Joined
Sep 7, 2011
Messages
395
Hi everyone, well Kian had his app at hospital yest with his ibd nurse to discuss the methotrexate injection. Still a lot to take in but feeling ok at the min about it all. Kian had a practice on dummy skin of the way to give himself the injection and he done superb, my hubi and myself also practiced too but I know it will be completely different when we have to actually do it for Kian.
His tummy etc felt nice and soft and she was happy with everything else so he had more bloods and his chest xray while we were there too. So, he starts the new med next Friday, I know for sure I will be a nervous wreck whereas it will go over Kians head and he will tell me stop worrying. I just really hope there is no nausea or sore heads, we were told he has to take folic acid the day before or after the shot so hopefully that will make a difference.
All I hope for that the mxt does its job. xxxx
 
We have no experience with Metho at our end dodie but I am sending loads of luck and well wishes that all goes well with the injections and this drug is just the ticket for your lad. :ghug:

Dusty. xxx
 
My kid is on Methotrexate and I was nervous to do injections at first. It gets easier the more you do it. She would get small bruises the day after and I always felt like crap. I finally learned the trick of icing the spot before and after injection. It makes a big difference. Make sure to keep rotating spots you inject. It helps.
 
Does your daughter get nausea with the mxt SupportiveMom and how long has she been on mxt? Thankyou for the advice too. xx
 
Yes she gets nauseated. We have Zofran if she needs it but only do it when absolutely necessary. It is expensive. She has been on metho since May 2013 after anaphylaxis reaction to Remicade.

I also do the injections right before bed so she tends not to be nauseated from the metho too much.
 
Does the folic acid help much with the nausea? maybe I should ask to get some antisickness tablets just incase he feels sick afterwards as the first few shots are getting done by a nurse after school on a Friday.... starting next week. After then we can do them at home before bedtime hopefully. xx
 
Folic acid doesn't do anything for us for nausea and I didnt know it was supposed to. We take it to keep the folate up in her blood stream as metho I think prevents a lot of it to get absorbed into the blood. Gravol has helped if you don't get a script for zofran.
 
My son does mtx injections. The needle is so small and so it works better in my hand. I thought I'd Never be able to give a shot. It was easier than I thought. I get more bothered now afterwards thinking about what I just injected...but I do that with every medicine! My son only felt nausea once and after zofran...felt great quick- So I think it may have not been connected. How much do you have to inject? We do 7ml due to his weight.
 
A just had her 4th shot last night. It really does get easier every time. We do it right before bed but with the last 2 shots she has vomited the following morning. Zofran does not stop her vomiting unfortunately (but I'm not 100% sure it is related to the mtx).

What do you all do with your vial of mtx when you are finished? I've given the 4 injections but there is still some medication left in the vial. Is it okay to just throw it in the trash or should I dispose of it some other way? I've been putting the used needles in a sharps container.
 
My 9yo son has been on MTX since July. I was nervous about the shot-so was he-but it is easier than you think. The hardest part for me was holding the syringe so that it wouldn't wiggle when I changed my hand position between poking him and pushing down the plunger. I figured out a way so I don't have to change my hand position at all, and that keeps the whole thing steady, which is more comfortable of course.

If the MTX has been refrigerated, let it warm to room temp before injecting. That will make it more comfortable. And try to pinch a large amt of flesh when doing the injection. We found that helps too.

We do folic acid every day, except injection day. They say it may help with nausea, but like Supportivemom said, I think it's main purpose is to help keep folate at the proper level in the body, as MTX can block it from being absorbed... or something like that. Guess I should read that article. Fortunately, my son has not had any nausea, but we have an anti-nausea med prescription, just in case.

We do the shot on Fri night in case of nausea or fatigue, as there's no school the next day. There was some fatigue in the beginning for my son, but that seems to have resolved.

Keep in mind that MTX may loosen the bowels. It did for my son, although in his case, that was a good thing.

Good luck!

DanceMom, we were told that anything that has MTX on it (or might have MTX on it) should go in the sharps container. So, I put the vials in, the cotton ball, my gloves (if/when I use them!), etc.
 
His ibd nurse said to give the folic acid the day before or day after if I did forget. I cant remember how much she said yesterday but the amount was very small. We had a few practices on the dummy skin of doing the shots too, will be nervous doing it the first time but defo rather do it at home before bed too, that's what we done with the 6mp too and thankfully he didn't suffer with nausea etc, hoping this will be same. xx
 
CrohnsKidMom said:
If the MTX has been refrigerated, let it warm to room temp before injecting.
Click to expand...

It doesn't have to be refrigerated does it? I checked and dbl checked with the pharmacist. We don't put it in the frig. Hope its been right!


We also do injection right before he goes to sleep. There has been differing things told by GI's on here. But we were told to do Folic Acid everyday. Even injection day
 
Grace does not mind hers at all. She would rather have the poke then the blood draw.
We also give it at night. She will have a quite day the next day be that's always a bad thing. lol
 
We were also told it doesn't need to be refrigerated, just to keep it out of sunlight. Ive seen a few posts also about the folic acid.... some take it every day but im sure she said to take it once a week on day before or day after?? will have to double check again. xx
 
The folic acid helps with the nausea i've heard. But I don't think that's why you take it with Mtx. The Mtx blocks your body of folic acid... something like that. So you need to supplement it back in. I'm sure someone on here can explain it much better. Some don't take it on injection day for better absorbtion of the mtx. I may be saying this wrong!
 
My son started MTX this week, he takes the pills instead of doing the shot. Honestly the doctor didn't say anything about the shot just the pills. He took his first pills on Monday night and he was fine that night and the next morning but then I got a call from school that his stomach was hurting. I knew it was from the medicine so I brought him home to just relax and by Wednesday he was fine again.
 
Hi griffin123, what was your son on before he started the methotrexate? I hope it does the trick for your boy. xxxx
 
Brian'smom, our GI I nurse told us to refrigerate it once the vial has been used the first time. Unopened vials do not need to be refrigerated. Perhaps this is just our GI office's recommendation.

Some GI's say to take folic acid every day, some every day except injection day, and some say just injection day. I don't know that there's been any concrete evidence as to what is best.

From what I understand, MTX in pill form can be hard on the digestive tract, whereas injections are more readily absorbed by the body. I know my son would have picked the pill if the GI had given him the choice however!
 
Jack did the pills as well the few months he was on Mtx. Never said anything about folic acid at the time so he did not take any while he was on Mtx.
 
dodie74 said:
Hi griffin123, what was your son on before he started the methotrexate? I hope it does the trick for your boy. xxxx
Click to expand...

My son was on 6MP and pentasa before we started MTX. The only reason why we switched is because he's starting Remicade tomorrow and they want him on Remicade and either 6MP or MTX and after I did a lot of research I decided Remicade and MTX seemed like a better combo than 6MP and Remicade.
My son's GI wants him to take folic acid everyday too while he's on the MTX
 
dodie! Your lad is growing up! Love your new avatar and your boy has gone from downright cute to downright handsome! :):):)

There are so many variables when it comes to folic acid supplementation with Methotrexate. Whether it be Metho’s role in depleting folate or folic acids role in negating the side effects of the Metho, as you have no doubt read and seen here and elsewhere. Much of the literature refers to Rheumatoid Arthritis and I think the only one that I would be wary of is perhaps the suggestion that no folic acid is required only because whilst that may be acceptable with RA they don’t have the added burden of intestinal disease. If Crohn’s is located in the ileum then there is the risk that you may already be or close to a folate deficiency. Easy enough to monitor though.

Dusty. xxx
 
My son's been on MTX (shot) for 2 1/2 years now. It stopped doing the job after 1 year so we added in Humira and he improved again. He's never had any real problems with it other than a little bit of nausea the time he forgot to take folic acid for the week (he does 1mg daily except for the day of and day after the shot).

We have never refrigerated it... just kept it out of the sunlight.

It can take a while to start working - hope you start to see improvement soon!
 
When should multi-dose vials be discarded?
Medication vials should always be discarded whenever sterility is compromised or questionable.
In addition, the United States Pharmacopeia (USP) General Chapter 797 [16] recommends the following for multi-dose vials of sterile pharmaceuticals:
If a multi-dose has been opened or accessed (e.g., needle-punctured) the vial should be dated and discarded within 28 days unless the manufacturer specifies a different (shorter or longer) date for that opened vial.
Click to expand...

From:

http://www.cdc.gov/injectionsafety/providers/provider_faqs_multivials.html


They don't put this on the label you have to ask about it.
Mtx is only good for 28 days once you puncture it.
So about three shots
Week four would need to be a new vial.

The med also loses its effectiveness past the date.
Mail order programs will provide smaller vials so there is less wasted med.
 
Brian'sMom said:
Has anyone else been told to refrigerate it?
Click to expand...

Storage: Injectable Methotrexate
• Store unopened vials at 15 – 25°C (59-77°F) & protect from light

Care of methotrexate injections:
• Store opened vials in outside shelf of refrigerator at 4°C (39.2° F) and protect from light.
• Preloaded syringes of methotrexate should be refrigerated in a plastic container. If unused, preloaded syringes should be discarded within 4 weeks.
• When travelling put injectable methotrexate in a cool bag with an ice pack.

http://www.arthritis.ca/document.doc?id=598
Click to expand...

Dusty. :)
 
Confused.. if the medication is good for 28 days, isn't the 4th one on day 28 and then would not be past expiration and good to use?
 
SupportiveMom said:
Confused.. if the medication is good for 28 days, isn't the 4th one on day 28 and then would not be past expiration and good to use?
Click to expand...

Yes, you can use the same vial for all 4 shots. A's first shot was 12/31 and her fourth shot was 01/21. That's only 22 days.

The nurse specifically told us not to refrigerate it. Guess I need to go read the bottle/pamphlet info again.....
 
I wonder what happens to it if you didn't refrigerate it. It can get germs in it... We always wipe the top of it with an alcohol wipe before we stick the needle in it.

Ok I just called the manufacturer on our vial. They said if it says "single use" (which ours does) it has no preservative in it. And she said that they cannot tell me we can even refrigerate it and use it again in a week. Advised me to talk to your pharmacist about different vials. Hmmmm We've been doing it this way since Nov 1.
 
Last edited:
Well, not long now til the first mxt shot for my boy :/ hes starting off with 0.6ml, what did everyones elses child start off with and do they change the dose accordingly? x
 
My daughter does oral MTX but yes we started low and gradually increase...not because of symptoms but because that is how the doc does it.
 
My daughter started at .1ml and we gradually increased to 1ml. When she started having side effects we went to .6ml.
 
We did oral and he took 6 pills once a week - I think they are 2.5mg so 15mg. Hope it does the trick for him.
 
Thanks everyone. it went fine. the nurse done his first shot but he wants to do the next one next Friday himself, im just soooo proud of the way he is handling it all. Kian is 10yo and 57lb at the min so im hoping the mxt gets the inflammation under control where its located at the ileum and he starts gaining weight. its a waiting game really as cant tell if its scarring or inflammation? time will tell.
 
That's great he did so well. Very brave to want to do the next one himself. Hope it works well
 

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