What to Expect When You Self-Inject RA Medication

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Certain rheumatoid arthritis (RA) drugs are administered by injection. Self-injection was introduced to make it more convenient and less expensive for the person living with the condition. It can give you a lot more freedom, rather than having frequent doctor’s appointments for a shot. We share information about self-injection, including tips from the RA community on Twitter and Facebook.


What RA medications are self-injected?

“Injecting methotrexate instead of taking pills is so much easier on my stomach.” — Leigh

Two kinds of RA meds may be self-injected. The first is methotrexate. If your doctor has prescribed this medication, you will usually start on tablets. This may be changed to the injectable version for a variety of reasons. Some of the biologic medications are also administered via injection. This can be done either with pre-filled syringes or an auto-injector pen.


From pharmacy to home

How you receive your meds can vary. You may be able to pick up some medication directly from the pharmacy. Others may be shipped to you. This may be especially so if the medication needs to be refrigerated, as is the case with biologics. They’ll be shipped in a container that keeps the medication cool between the pharmacy and your fridge.


How often do I have to self-inject?

“I tend to do mine at the end of the day so I can totally relax afterward.” — Sally

Medications have a recommended dose and schedule and these vary from drug to drug. The most commonly used schedules are every week or every other week. Depending on how active your RA is, your doctor may recommend you increase the manufacturer recommendation, either in terms of dosing or schedule. The goal is for the medication to control your RA and sometimes that means increasing dose or schedule.


How do I store the medication?

How you store the medication depends on the drug. For instance, methotrexate is usually stored at room temperature, although there may be some types that should be refrigerated. Injectable biologics should always be kept in the fridge. It’s important to keep the medication and your supplies — especially syringes — away from children. It’s also a good idea to educate your kids and the rest of your family about the medication so people stay safe and the drug is effective.


How do I learn to inject myself?

“I give my injections on my stomach — hurts a lot less than the legs — but (I) admit it took me some time to work up the courage!” — Laurie

The thought of sticking needles into your body can be intimidating. Don’t worry, your doctor or their nurse will teach you how to do it. If you’ve ever had injections before, you know the basics: Swipe the area with an alcohol swab, pinch the flesh, inject the medication, then hold a piece of gauze at the injection site for a bit before you put on a Band-Aid.


How do I self-inject if I’m afraid of needles?

“Self-inject (is) not as scary as it seems.” — @2MVCXO

If you are needle phobic, talk to your doctor. When choosing a medication for you, it may be best to select one that can be administered through auto-injector pen. It looks like a giant Sharpie and the needle is invisible. You put one end against where you’ll be injecting and press the button on the other end. Someone in your family may also be willing to help you, although the independence of doing it yourself can make the process easier.


How do I prepare the medication?

“Make sure the biologics are room temp.” — @crazyladeSCREAM

Your doctor or their staff will teach you how to prepare the medication for injection. If you need to fill a syringe yourself, they’ll show you how. Refrigerated medications can sting going in, so leave them out of the fridge for a bit before injecting. Make sure you speak to your pharmacist about this as some drugs may lose effectiveness if they are out of the fridge for too long. Another option is to warm the syringe in your hands.


Where do I inject the medication?

RA meds can be injected in two places: intramuscular (thigh or upper arm muscle) or subcutaneous (stomach fat). Some people find that injecting subcutaneously can be a bit less painful than the medication going into a muscle; others don’t. Finding the best area for you can involve some trial and error.


What does it feel like to self-inject?

“I always pinched the skin together and injected into that, then put an ice cube on it for 30 seconds or so.” — Caryl

The medication going in can sting a bit (some quite a lot). It can be easier injecting subcutaneously, such as in your stomach fat, rather than intramuscular in your thigh or upper arm. Pinching the area hard and holding the pinch as you inject can also reduce the sting.


What do I do with the syringes or pens?

When you are provided with the medication and the supplies for it, you will also be given a hard plastic sharps container for biomedical waste ( the syringes or auto-injector pens). You should dispose of it once it is about three quarters full. It is important that you don’t just throw it in the garbage. Your pharmacist or the support program for your biologic will tell you what to do.


What happens after I inject the medication?

In the long term, injecting the medication will hopefully make you feel better. In the short term, you may get a bit of an injection site reaction, such as swelling like a mosquito bite or a bit of a rash. Talk to your doctor about what you can expect and which symptoms mean you should contact a physician.


What if I have questions?

You may be doing the injecting yourself, but that doesn’t mean you are alone. Your doctor and their staff will be available to answer your questions and give you more training if you need. As well, biologic medications have a support program with nurses available to answer your questions. When you start a biologic, you will be given information about the program.