Q: Are the side affects (nausea,lack of energy)from metho any less severe with the injected vs pill?
I was on methotrexate for a couple of years and started out with the pills. As the dose increased, I started having quite a bit of trouble dealing with the side effects, nausea specifically and we changed to injections. It definitely helped with the stomach-related symptoms - I was much less nauseated. However, I did have some for a few days after each dose and I'd manage that with light meals of relatively bland food, plus lots of hot water with a small slice of lemon (settles the stomach). Peppermint or ginger tea also helps with an upset stomach.
In terms of the fatigue, I don't remember it changing very much when I moved to injectable methotrexate, but I do remember that over time, as my body got more used to the drug, it had less of an impact on my life. What probably helped as well was that once I got used to the rhythm of it, knowing that I would have a couple of days of lower energy after my shot, I rearranged my life so I could rest more for a day or two after the injection.
I have used both the pills and the injections and yes, the pills seem to cause less nausea. There is also a medication I have taken in the past with either the pills or injections usually when I first take the MTC and then about 6 hours later that prevents the side effects. Your doctor would probably know the name of drugs that prevent the side effects. I also found after months of taking MTC that I don't have much in the way of side effects, but I have been taking it for years now in fairly large amounts.
I've been taking MTX for about four months started out low (10 mg) and now I've been at my current dose (25 mg) for about 2.5 months. Just the past 3-4 weeks I've noticed that I get slightly nauseous right around dinner time on Sunday (I take my MTX at about 11 PM every Saturday evening). The nausea usually passes in a few hours though. I'm also tired a good part of the time but I don't really know if it has any connection to the MTX or if I'm just tired like many other working moms. Overall I've think I've tolerated the MTX in pill form pretty well. Everyone is different as is their tolerance for pain or any other symptoms. You should discuss with your doctor what or if any side effects you are experiencing to decide how tolerable or not they are. My game plan is to manage the symptoms with the least intrusive forms of medication saving the stronger stuff (like any form of injectable). You and your doctor are a team in dealing with this disease. Best of luck to you.
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