How to use them

Getting your methotrexate injections

We work with a homecare pharmacy to deliver your methotrexate injections to you. This service is free.

We’ll ask for your consent to share your information with the homecare pharmacy so that we can open an account for you. This includes your:

• name
• date of birth
• diagnosis
• contact details

The homecare pharmacy will contact you to confirm your personal details and arrange your first delivery. After that, your injections will be delivered every 8 weeks.

If it looks like you’re going to run out of injections before the next delivery, let us know at least 2 weeks before you run out.

Your first injection

Once you’ve received your first delivery of methotrexate injections, we’ll contact you to arrange a home visit. This visit usually happens a few weeks after we send your prescription to the homecare pharmacy.

We’ll show you how to give yourself the injections. Most people feel confident injecting methotrexate by themselves after this visit. If you would like more support, your nurse can arrange a second visit.

Do not use your methotrexate injections if you’re unsure about your dose.

Using methotrexate injections

Inject a single dose of methotrexate one day each week. This should be the same day of the week, for example, every Monday.

You might need to take methotrexate for up to 12 weeks before you start to notice it working. If this happens, it’s important to continue your treatment. It’s likely that the methotrexate is working without you realising it.

Depending on how well the methotrexate works for you, your doctor might increase or decrease your dose.

If your dose changes, you still only need to have one injection each week.

Always check the dose is correct and the expiry date has not passed. Call NHS 111 immediately or go to your nearest A&E if you think you’ve taken more than your prescribed dose.

If you forget to use your injection

If you forget to inject your methotrexate, use it the next day or the day after. This day should become your new regular day for taking the injection.

For example, if your regular injection day is Tuesday, you can inject it on Thursday instead. Thursday would become your new regular injection day.

If your injection is more than 2 days late, talk to your speialist doctor or nurse. It’s unlikely that your condition will get worse during this time, but it’s best to get advice.

Throwing away methotrexate injections

You’ll get a special bin for your auto-injectors called a sharps bin. Put all your used auto-injectors into your sharps bin.

When your sharps bin is full, tell the homecare pharmacy. They will collect the sharps bin when they deliver your injections.

If your treatment ends and you have injections left over, return them to the homecare pharmacy or bring them to hospital.

Do not throw away methotrexate injections with your normal household waste.

Taking folic acid

Folic acid helps to reduce the side effects of methotrexate. It usually comes in 5mg tablets that are round and yellow.

You'll usually take 1 tablet a day, except for the day you use your methotrexate injection. Your doctor will explain how to take your folic acid.

If you forget to take your folic acid, you can take it as soon as you remember. If it’s the same day as your methotrexate injection, take your folic acid the next day instead.

We’ll give you a one-off prescription for folic acid tablets when you start your methotrexate treatment. Ask your GP for a repeat prescription so that you do not run out.

Tests during treatment

It’s important we make sure that methotrexate injections are safe for you. You’ll have regular blood tests during your treatment to check if the methotrexate is working and if it’s causing any side effects.

If the tests show that the methotrexate is affecting your blood, liver, kidneys or lungs, we might change your dose.

Your doctor will tell you how often you need to have a blood test. If your blood test results are stable, we might ask you to have a blood test every 3 months. If your doctor thinks we need to check on you more regularly, you might need to have a blood test every 2 weeks.

If your blood test is on the day that you usually take your methotrexate, wait until after your blood test to take it. This helps your blood test results to be more accurate.

Do not miss your blood tests. You must not inject methotrexate unless you’re having regular blood tests.

 

If you miss your blood tests or check-up appointments, we will stop prescribing methotrexate for you.