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Medications > Methotrexate > Methotrexate | Self-Inject

Methotrexate | Self-Inject

Watch our video on how to correctly give a subcutaneous injection of methotrexate.

Video Explanation of Self-Injection of Methotrexate

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Injecting Methotrexate Under the Skin

We’re going to teach you how to perform an injection of methotrexate under the skin. This is also known as a subcutaneous injection or subq injection.

But there’s an important concept about these injections you need to understand. When you take a tablet the small blood vessels in the stomach and bowel absorb the medication. A subcutaneous injection leaves a small amount of medication under the skin. Just like in the stomach, the small blood vessels absorb the medicine but this time they’re in the skin!  So you can be assured that you aren’t injecting the medicine straight into the blood!

Today we’ll be demonstrating using a 2 mL vial of methotrexate and a 1 cc insulin syringe.

In some areas, Methotrexate also comes in a prefilled syringe.  For information on how to inject please see our video on injecting using a pre-filled syringe.

Each syringe has 4 basic parts:

  1. A needle cap (which is removed)
  2. A needle
  3. A barrel which contains the medicine
  4. And a plunger

Ok, lets get on with the injection.  We’re going to teach you how to inject using four basic steps:

  1. Step 1: Gather your supplies
  2. Step 2: Prepare the medication
  3. Step 3: Choose an injection site
  4. Step 4: Inject the medicine
  5. Step 5: Dispose of the syringe

Step 1: Gather Your Supplies

At we’ve prepared a special “injection placemat”.  This will help to make sure you’ve got all of the necessary supplies. Place your “injection mat” on a clean table or surface.  You’ll need: Your syringe, A vial of methotrexate, A clean gauze or tissue, and finally a puncture proof “sharps container” to dispose of the used syringe. If you’re missing any of the supplies, talk to your local pharmacist.

Step 2: Choose the Injection Site

It’s important to start by washing your hands thoroughly with soap and water.

A subcutaneous injection can be given into the thigh, the abdomen, or the upper arm. It’s best to choose a different site for each injection at least an inch away from a previous injection.

You can easily inject into your abdomen or thighs but you’ll probably need help from another person if you want to inject into your upper arms. It’s a good idea to rotate your injection sites.  For example, this week you might place the injection in your thigh and next week your abdomen. You can also use the upper arm if someone else is injecting. If you’re injecting into your abdomen stay away from the 2 inches around your belly button. Don’t inject into an area that is tender, bruised, red, hard, or one that has scars or stretch marks.

Step 3: Prepare the Medication

  1. Remove the protective cap from the top of the vial of methotrexate to expose the rubber stopper.
  2. Remove the needle cap and draw air into the syringe to the amount of methotrexate you are injecting.  For example if you are taking 15 mg you’ll draw the syringe back to 0.6 cc’s and if you’re taking 20 mg you’ll draw back to 0.8 cc’s.
  3. Insert the needle through the centre of the rubber stopper. Push the plunger down to push the air into the vial.
  4. Slowly pull back on the plunger to draw up the right amount of medicine. Remove the needle from the vial.

Step 4: Inject the Medicine

Pinch a fold of skin at the injection site. Gently insert the needle at a 45-degree angle under the skin. Release the skin and slowly inject the medicine. When the syringe is empty remove the needle.  Apply pressure with a cotton gauze or tissue for about 10 seconds.  It’s normal to see a tiny drop of blood.

Step 5: Dispose of the syringe

It’s important to dispose of used sharp syringes in a proper container. These containers can be found at your local pharmacy.  They are often referred to as “Sharps containers”. Don’t ever put the needle cap back on the needle as you or someone else may accidentally poke themselves with the needle.  Simply take the used needle and place it in the Sharp’s container.  Store the container in a safe place out of reach of small children. When the container is 2/3 full, tape the lid closed and discard of it as instructed by your local pharmacist.

Giving a small injection of methotrexate under the skin is really just that easy. If you have any questions or concerns please talk to your doctor or your nurse.