How to Use the Otrexup Autoinjector
Otrexup is a single-use, prefilled autoinjector that delivers subcutaneous 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. Always follow your doctor's instructions and the FDA-approved prescribing information.[1]
Step-by-Step Injection Instructions
- Wash hands and clean the injection site (thigh, abdomen except 2 inches around navel, or outer upper arm with help) with alcohol; let dry.
- Check the label for the correct dose and expiration; do not use if solution is discolored or past expiration.
- Remove the cap by pulling straight off; do not twist.
- Hold the autoinjector with the green activation button facing away from skin. Place the white tip firmly against the clean site at a 90-degree angle.
- Press the green button firmly until it clicks and the window turns orange (indicating injection start). Hold steady for 5 seconds after the second click (total ~10 seconds); a louder second click signals completion.
- Lift straight up; a yellow safety sleeve covers the needle. If no orange in window, do not reuse—contact your doctor.
- Dispose of used autoinjector in a sharps container; do not recycle.
Inject once weekly, same day/time, rotating sites. Prime only if prescribed (hold upright, press button briefly without skin contact).[1][2]
Where to Inject and Site Rotation
Preferred sites: front thigh (mid-section), abdomen (avoid 2 inches around belly button), or upper outer arm (needs assistant). Alternate sites weekly to reduce irritation. Avoid scarred, bruised, or tender areas.[1]
What If Something Goes Wrong?
- No click or incomplete dose: Check window—if not fully orange, call doctor/pharmacist for replacement; do not inject again.
- Bleeding or leakage: Apply pressure with gauze; small amounts are normal.
- Accidental injection: If into finger/eye, rinse immediately and seek medical help.
- Expired or damaged: Discard safely; do not use.
Storage and Handling Before Use
Store in refrigerator (36-46°F) but allow to warm to room temperature (30 minutes) before injecting for less pain. Can stay at room temp up to 7 days. Keep away from heat, light, children.[1]
Common Patient Concerns During Use
Pain is often mild; ice site beforehand if sensitive. Watch for injection site reactions (redness, itching). Full training video available on Otrexup.com or via pharmacist demo. First dose usually in-office.[2]
[1] Otrexup Prescribing Information, Antares Pharma, https://www.otrexup.com/hcp/pi
[2] Otrexup Patient Instructions for Use, https://www.otrexup.com/patient/instructions-for-use