Methotrexate injections


Hello everyone,

I had my first methotrexate injection yesterday and have been feeling very nauseous and generally rubbish since, my question is can anyone tell me roughly how these symptoms last each time and does it get better ?? Also any hints and tips that you have tried that make the symptoms better? Thanks x


  • Hello @Moonshaddow, welcome to the Online Community! It's lovely to have you here.

    I see you have recently started mtx injections and would like to know how long symptoms might last and if there is any way to improve them. I'm sure other members will have advice from personal experience, but for now here is a quote from the Versus Arthritis website that you might find useful:

    "There are four ways of tackling this problem. Firstly, as you point out, folic acid taken on the non-methotrexate days can help. There's a trend for people to take folic acid just once or twice a week so, if this applies to you, there's an option of increasing the dose to six days a week. Secondly, your doctor or nurse can give you an additional pill to stop the nausea. This need only be taken on the same day as methotrexate. Thirdly, if you're taking methotrexate tablets there's an option to convert to methotrexate by injection – quite a lot of my patients do this and find it more effective and less likely to cause sickness. Fourthly, if all else fails, the dose of methotrexate can be reduced, but this may require you to take additional treatment to keep your disease under control."

    This answer was provided by Dr Philip Helliwell in 2009, and was correct at the time of publication.

    And here is the page on methotrexate if you would like an overview of the drug, including side-effects and risks: Methotrexate | Side-effects, uses, time to work (

    Do let us know how you get on, and in the meantime I hope you'll continue to browse and participate in the Online Community :)

    Best wishes, Sarah (mod)

  • bubblegum226

    I started injections 5 weeks ago after not being able to tolerate the tablets , first two weeks I felt nauseous and very tired the day later, as the weeks have gone by the nausea has gone, the tiredness isn't as bad so worth persisting, try taking folic acid for two days after injection and if that helps maintain , get as much rest as possible and try avoid caffeine as can make you feel worse. I found switching to decaf coffee and tea helped and cutting down on carbs , lighter smaller meals so not getting that heavy bloated sensation in your tummy, I've lived with undiagnosed RA for 20 years and was only diagnosed at the age of 32 , I hope this helps