Methotrexate (MTX) is a medication that healthcare providers prescribe for various conditions. While it is available in oral forms, injections offer an alternative administration method. This article guides you through injecting methotrexate, covering preparation, technique, and safety.
Purpose of Methotrexate Injections
Injected methotrexate treats various conditions, leveraging its immunosuppressive, anti-inflammatory, and anti-cancer effects. It commonly treats autoimmune diseases like rheumatoid arthritis and psoriasis, reducing inflammation and slowing disease progression. It also treats certain cancers by inhibiting cell growth.
Injectable methotrexate is often preferred for its more consistent absorption compared to oral tablets. This ensures the medication reaches therapeutic levels reliably, leading to better treatment outcomes. Injections may also cause fewer gastrointestinal side effects or be necessary for higher doses. A healthcare professional always decides on injectable methotrexate, tailoring it to the patient’s condition and needs.
Getting Ready to Inject
Before injecting, gather all necessary supplies and prepare your environment. Supplies include the pre-filled methotrexate syringe or vial, alcohol swabs, a clean cotton ball or gauze, and a sharps disposal container. Keeping items within reach maintains sterility and streamlines the procedure.
Store methotrexate at room temperature, away from heat, light, and moisture, unless your pharmacist instructs otherwise. Wash your hands thoroughly with soap and water for at least 20 seconds before handling supplies. This reduces the risk of infection at the injection site.
Select an injection site, such as the abdomen (avoiding the navel area) or upper thigh. Rotate injection sites with each dose to prevent skin irritation, scarring, or changes in medication absorption. Inspect the methotrexate solution for clarity and absence of particles or discoloration. If using a pre-filled syringe, your healthcare provider will advise if a small air bubble needs removal or can be injected.
Step-by-Step Injection Process
Once preparations are complete, proceed with the injection. First, clean the chosen injection site thoroughly with an alcohol swab, wiping outwards from the center. Allow the skin to air dry completely; injecting into wet skin can cause stinging. This disinfects the skin and minimizes infection risk.
Once dry, gently pinch a fold of skin at the cleaned site. This lifts subcutaneous tissue, ensuring medication delivery into the fatty layer beneath the skin. Hold the syringe like a dart and swiftly insert the needle straight into the pinched skin at a 90-degree angle. If very thin, your healthcare provider might advise a 45-degree angle to ensure the medication enters the subcutaneous layer without reaching muscle.
Once inserted, slowly push the plunger to inject the methotrexate. Injecting gradually over several seconds minimizes discomfort and allows tissue to accommodate the fluid. After the syringe is empty, wait a few seconds before smoothly withdrawing the needle at the same insertion angle. Releasing the pinched skin immediately after needle removal can help prevent bruising.
Gently press a clean cotton ball or gauze over the injection site for a few seconds. Do not rub the area; rubbing can irritate tissue and potentially spread medication into surrounding areas. Always follow your healthcare provider’s specific instructions for the injection technique, as they may have tailored advice.
After the Injection and Important Safety Information
Immediately after injection, proper disposal of the used syringe is crucial to prevent accidental needle sticks and ensure safety. Place the used syringe, needle first, into an approved sharps disposal container. These containers safely hold sharp medical waste and should be kept out of reach of children and pets.
Monitor the injection site for unusual reactions like excessive redness, swelling, increased pain, or warmth, which could indicate infection. While mild redness or tenderness is common, persistent or worsening symptoms warrant contacting your healthcare provider. Also be aware of potential systemic side effects, which may include nausea, fatigue, mouth sores, diarrhea, or hair loss.
Methotrexate interacts with other substances and medications, so discuss all current medications and supplements with your doctor. For instance, avoid or severely limit alcohol due to liver damage risk when combined with methotrexate. Certain medications, like NSAIDs such as ibuprofen or naproxen, can also interact, potentially increasing methotrexate levels and leading to more side effects.
Many taking methotrexate are prescribed folic acid supplements to reduce side effects like mouth sores and gastrointestinal issues, without diminishing drug effectiveness. Women of childbearing potential must be aware that methotrexate can cause severe birth defects, making effective contraception essential during treatment and for a specified period after discontinuation. This information is a general guide and does not replace personalized medical advice from a healthcare professional.