This webpage is intended for UK patients who have been prescribed Metoject® PEN (methotrexate). If you are not, please click here.

The first injection of subcutaneous methotrexate PEN should be performed under direct medical supervision. However, your doctor may decide that you can learn how to inject subcutaneous methotrexate PEN yourself. You will receive appropriate training for you to do this. Metoject® PEN is injected once weekly.

Metoject® PEN

(methotrexate)

Metoject® PEN is a pre-filled methotrexate auto-injector. 
The first injection of subcutaneous methotrexate PEN should be performed under direct medical supervision. However, your doctor may decide that you can learn how to inject subcutaneous methotrexate PEN yourself. You will receive appropriate training for you to do this. Metoject® PEN is injected once weekly.1

Understanding methotrexate 

Methotrexate is part of a group of medicines known as immunosuppressants and works by slowing down the body’s immune system2.
This stops the body from attacking itself, which has the effect of reducing the swelling and inflammation that causes swollen and stiff joints in rheumatoid arthritis, the thickened skin in psoriasis or damage to the bowel in Crohn’s disease3.

Using subcutaneous methotrexate PEN

Patient self-injection guide

The subcutaneous methotrexate PEN is a single use device and is injected  ONCE  a week. 

Please read the following instructions carefully. 

1. Clean the injection site. Remove the cap straight off.
2. Position the uncapped blue needle cover at a 90-degree angle against the skin. It is not necessary to build a skin fold.
3. Start the injection by pushing the pen down all the way (a first “click” indicates the start of injection).
4. Hold the pen down against the skin to complete the injection until:
✓ you hear a second “click”, shortly after the first
✓ or: the blue plunger rod has stopped moving and fills the inspection window
✓ or: 5 seconds have passed
5. Finishing the injection: Remove the Metoject PEN from the skin at the same 90-degree angle. The blue needle cover automatically moves into place over the needle and is then locked.
6. Dispose of the pen in accordance with local requirements.

How to use your Metoject® PEN

Getting to know subcutaneous methotrexate PEN

Storage
Store below 25 C. Do not freeze. Keep the pre-filled pens in the outer carton in order to protect from light. The shelf life is 30 months1.

Air Bubble
If an air bubble is visible through the transparent control zone, do not try and remove it, as it will not affect the dose or cause harm.

Disposal
The subcutaneous methotrexate PEN is a single use autoinjector and cannot be refilled. After use, the pen should be disposed of in a purple topped cytotoxic sharps bin or as instructed by your healthcare professional (HCP). All other waste can be disposed of in the normal household waste.

Travelling with subcutaneous methotrexate PEN
The subcutaneous methotrexate  PEN should be kept in its original packaging and you should carry it in your hand luggage. This prevents your subcutaneous methotrexate PEN from getting lost and the storage temperature of below 25 C can be maintained. Should the temperature rise above 25 C in the aircraft cabin, you should ask a flight attendant to store your subcutaneous methotrexate PEN in a fridge on board. If you plan to travel to warmer areas, you should consider carrying a small cooling box for the transport from the airport to your hotel.

In the event of unexpected travel delays, it is advisable to carry additional subcutaneous methotrexate PENs with you. If you require documentation to confirm that you need to bring your subcutaneous methotrexate PEN for therapeutic reasons when entering a foreign country, a travel certificate is included in your starter pack. Completed forms are generally accepted in most countries.

Guidance for the use of subcutaneous methotrexate PEN

To receive a physical copy of support materials, please ask your healthcare professional or order a copy here. 

Order Support Materials

Guidance for Adults and Adolescents Prescribed subcutaneous methotrexate PEN

For more information on how to use or administer the subcutaneous methotrexate PEN in adults
Using your subcutaneous methotrexate PEN

Guidance for Children Prescribed subcutaneous methotrexate PEN

For more information on how to use or administer the subcutaneous methotrexate PEN in children
Using your Child's subcutaneous methotrexate PEN

The subcutaneous methotrexate PEN Travel Certificate

Subcutaneous methotrexate PEN Travel Certificate

Frequently asked questions

It can take usually 4 – 8 weeks before there is any effect to treatment. You will be monitored regularly so do not alter your treatment or stop taking it without speaking to your healthcare professional first1.

How many doses are in subcutaneous methotrexate  PEN?

The PEN is a single use device and will deliver only one dose. 

What should I do to confirm the medication has been successfully delivered by Metoject® PEN?

Position the uncapped blue needle cover at a 90-degree angle against the skin. It is not necessary to build a skin fold.

Start the injection by pushing the Metoject® PEN down all the way (a first “click” indicates the start of injection).

Continue holding the Metoject® PEN down against the skin to complete the injection until:

✓ you hear a second “click”, shortly after the first

✓ or: the blue plunger rod has stopped moving and fills the inspection window

✓ or: 5 seconds have passed1.

Please click here to see the video on how to use your Metoject® PEN.

The subcutaneous
methotrexate PEN Reminders

  • The subcutaneous methotrexate PEN must only be injected once a week

  • Always inject on the same day each week 
  • Do not take oral methotrexate if you are taking subcutaneous methotrexate  PEN 
  • If you forget to inject the subcutaneous methotrexate  PEN on the correct day, contact your healthcare professional for advice 
  • Avoid drinking large amounts of alcohol, as methotrexate can cause liver damage 
  • Avoid pregnancy whilst being treated with subcutaneous methotrexate PEN, as methotrexate can cause birth defects, harm the unborn child or cause miscarriage  
  • Stop breast-feeding prior to and during treatment with subcutaneous methotrexate PEN
  • Regular monitoring is important 
  • If you experience tiredness, dizziness or drowsiness during treatment, do not drive or use machinery
  • If you are a sexually active male, you must use effective contraception during treatment, and for at least three months after stopping treatment
  • If you are a sexually active female, you must use effective contraception during treatment, and for at least six months after stopping treatment
  • Contact your healthcare professional urgently if you develop a dry cough or become breathless whilst being treated with the subcutaneous methotrexate PEN
  • Methotrexate can interact with other drugs so please check with your healthcare professional before you take any other medication
  • Check with your healthcare professional if you need any vaccinations

Treatment Categories

Please select the relevant link below for methotrexate usage information for dermatology or rheumatology. 

Reporting of Side Effects

If you get any side effects, talk to your healthcare professional. This includes any possible side effects not listed in the Patient Information Leaflet contained within your subcutaneous methotrexate PEN carton.   

You can also report side effects directly via the Yellow Card Scheme at yellowcard.mhra.gov.uk.   

By reporting side effects, you can help provide more information on the safety of this medicine. 

Further Information & Questions

Visit our contact page to submit an enquiry   

References:

  1. Metoject® Summary of Product Characteristics. [online] Available at:  https://www.medicines.org.uk/emc/search?q=metoject#gref/. Last Accessed July 2025

  2. About Methotrexate. NHS.uk. [online] Available at:  www.nhs.uk/medicines/methotrexate/about-methotrexate/. Last Accessed July 2025.

  3. Common Questions about Methotrexate. NHS.uk. [online] Available at:  www.nhs.uk/medicines/methotrexate/common-questions-about-methotrexate/. Last Accessed July 2025.

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