Methotrexate - Self Injection - Newcastle Hospitals NHS Foundation Trust

What is Methotrexate and what is it used for?

Methotrexate is a drug that suppresses your immune system and lowers your immunity (immunosuppressant). Its exact way of working in skin disease is unknown, but it can be very effective in reducing the inflammation in your skin, and ultimately improving or clearing your skin condition. Methotrexate is a cytotoxic drug and can either be given by mouth or via an injection.

What is the process of teaching methotrexate self-injection?

You will initially be given information about Methotrexate and should discuss this thoroughly with your healthcare professional. You can then decide if you are happy to go ahead with treatment.
A member of our team will show you how to prepare to give the injection.
Following this, you will be able to prepare the equipment and give the injection under supervision. You may need to attend on several occasions before you and the nurse are both happy that you can do this yourself at home.
Finally, you will prepare and give the injection at home as prescribed.

At each of these stages you will be asked to sign that you have successfully completed the step and are happy to move forward to the next part of training. There is no set amount of appointments and we will support you through your journey until you feel confident.

Special Precautions

Methotrexate is only given once per week. Please keep to the same day of the week if possible, although it is possible to take it up to 48h late if you forget to take it.
If you accidentally take too much or take it too frequently, contact your healthcare professional or attend A&E immediately as this can lower your immune system too far. Early treatment can reverse this.
Methotrexate can interact with other drugs (e.g. trimethoprim, co-trimoxazole, phenytoin and anti-malarial drugs) so always check with a doctor or pharmacist before taking any other medicine or herbal supplements.
Do not handle or use during pregnancy or breastfeeding, or if actively trying to conceive (men and women).
Store the medicine in a safe place out of the reach of children and pets.
Wash your hands after handling the medicine.
Live vaccines should preferably be avoided. Please speak to your healthcare professional if you need these.
Do not take if you have an infection or feel unwell.
If you are having any type of phototherapy then the injection site should be covered throughout your treatments.

How to administer the injection?

Check you have the right equipment:

Methotrexate for injection (check the dose is correct and it’s in date)
Clean table surface
Cytotoxic labeled sharps bin
Cotton wool ball

Wash your hands for 20 seconds.

Choose your injection site.

Gently pinch the skin together and insert the needle at an angle of 90º. Inject the methotrexate (press and hold for 5 seconds) until all of the medicine is injected.

Withdrawn and press gently on the areas with a cotton wool ball.

Dispose of the used syringe in the sharps bin along with the cotton wool ball.

Update your injection record.

How do I manage a spillage?

On the skin	Wash area with soap and water. Contact your doctor for advice if you experience any adverse effects.
In the eyes	Wash the eye(s) using plenty of water. Seek medical advice.
On work surfaces and floors	Blot dry with a paper towel and dispose of this in the cytotoxic waste bin. Wash area with soap and water.
On clothing	Blot dry with a paper towel and dispose of this in the cytotoxic waste bin. Wash clothes separately with soap and water.

Useful sources of information

British Association of Dermatologists (BAD)

www.bad.org.uk

DermNet NZ

www.dermnetnz.org

For Further Information

Medicines Information Patient Helpline:

Tel: 0191 282 3016. Available 9am to 4pm, Monday to Friday (excluding Bank Holidays). This helpline is available for patients of the Newcastle upon Tyne Hospitals, to answer any questions they may have regarding their medicines.