How to Inject Otrexup
Otrexup is a single-use autoinjector delivering methotrexate for rheumatoid arthritis, psoriasis, or polyarticular juvenile idiopathic arthritis. It comes in strengths from 7.5 mg to 25 mg per 0.4 mL dose. Administer subcutaneously once weekly on the same day each week. Store in the refrigerator but let it warm to room temperature for 30 minutes before use.[1][2]
1. Wash hands and clean the injection site (abdomen or thigh) with alcohol; avoid 2 inches around the navel.
2. Remove the cap from the autoinjector.
3. Hold the injector firmly against the skin at a 90-degree angle.
4. Press the green plunger button fully; hold for 5 seconds until the orange needle cover locks over the needle.
5. Dispose of the used injector in a sharps container; do not recap or reuse.
Do not shake, freeze, or expose to direct light. Use within 5 minutes after warming.[1][2]
Where to Inject Otrexup
Inject into the outer thigh or abdomen (except a 2-inch circle around the belly button). Rotate sites weekly to avoid irritation. Avoid scarred, bruised, or tender areas. Caregivers should inject into the patient's abdomen or thigh, not their own.[1][2]
What If I Miss a Dose
Take the missed dose as soon as possible if within 2 days. If more than 2 days late, skip it and resume your regular schedule. Do not double up.[1]
Common Side Effects and Precautions
Watch for injection site reactions (redness, pain, itching). Serious risks include low blood cell counts, liver damage, lung problems, and infections—get blood tests as directed. Avoid alcohol, live vaccines, and NSAIDs without doctor approval. Not for use in pregnancy; use contraception.[1][2]
Women who miss their period should test for pregnancy before injecting.[1]
Dose Adjustments and Monitoring
Start at the lowest effective dose (e.g., 7.5 mg weekly). Doctors adjust based on response and blood tests every 1-3 months initially, then every 8-12 weeks. Maximum is 25 mg weekly.[1][2]
Traveling with Otrexup
Carry in original packaging with prescription label. Keep refrigerated if possible; unrefrigerated doses are stable for 48 hours. Inform security about needles.[2]
Consult your doctor or pharmacist before first use; follow the FDA-approved Instructions for Use in the package.[1]
[1]: Otrexup Prescribing Information (FDA)
[2]: Otrexup.com Instructions for Use