Both my daughters have been on MTX. One has juvenile spondyloarthritis and Crohn's and the other just has juvenile spondyloarthritis. They are not twins though.
My older daughter is still on MTX. She has been on it for years. She has no issues with it. She does the injection - it's a teeny tiny needle and a very easy shot. She does it in her belly and started doing it by herself as a teenager. She says she barely feels it.
You can use Buzzy to help with the pain - she says with Buzzy she can't feel it at all!
https://buzzyhelps.com
Ice can also help with the shot.
She does it on a Saturday night so she has Sunday to rest. She is usually a bit tired the next day and a little nauseous. If nausea is really bothering her, she takes Zofran.
Folic acid is also given to prevent side effects. We started off with 1 mg daily, but for my girls that wasn't enough. They started getting mouth ulcers and bad nausea, so we upped it to 2 mg daily. That took care of the mouth ulcers.
My girls both did better on the injections of MTX, but some kids do better on the pills. GIs sometimes prefer to use injections because the absorption is better since it bypasses the gut.
We started out with pills but switched to injections when they had side effects with pills.
My younger daughter had a hard time with MTX. She had extreme nausea and dizziness and fatigue with it. She would even vomit. We tried everything to make it work because it worked really well for both her arthritis and Crohn's.
But in the end, we switched her to another medication.
Her experience is NOT typical though - MOST kids do great with MTX. My older daughter has very minor side effects - honestly, it doesn't really bother her at all.
MTX is a safe medication that has been used for years. We have gone anywhere from 7.5 mg to 25 mg. Both girls also take a biologic.
Definitely check out the parents' forum - there are lots of parents there who have young kiddos.
