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Introducing the NEW button-free Metoject® PEN

Offering the simplicity of a button-free autoinjector, purpose designed with patient-friendly features – Available from March 2024

Metoject® PEN For Rheumatology

Metoject PEN® is used to treat active rheumatoid arthritis in adult patients, polyarthritic forms of severe, active juvenile idiopathic arthritis and psoriatic arthritis.1

The National Rheumatoid Arthritis Society (NRAS) describes methotrexate as the ‘gold standard’ disease modifying anti-rheumatic drug (DMARD) for the control of inflammatory arthritis.8

Why use Metoject® PEN to Treat Rheumatoid Arthritis?

Clinical research has shown several benefits of Metoject® PEN and subcutaneous methotrexate administration, including:

The bioavailability of subcutaneous methotrexate is higher compared to oral methotrexate.1,3

In dosages between 7.5mg/m2 and 80mg/m2 body surface area, the bioavailability of subcutaneous methotrexate is nearly 100%, while the mean bioavailability of methotrexate absorbed from the gastrointestinal tract is approx. 70% with considerable inter- and intra-individual deviations.

Subcutaneous administration of methotrexate with Metoject® PEN resulted in a higher relative bioavailability compared to oral administration of methotrexate after single doses of 7.5mg, 15mg, 22.5mg, and 30mg.

Methotrexate for Rheumatoid Arthritis Patient Support Videos

Understanding methotrexate – this video tells you all you need to know about how Methotrexate works, its benefits and possible side-effects.

In this introduction video we are joined by Tracy French, Rheumatology Clinical Nurse Specialist at University Hospitals Bristol. Tracy runs through the ‘ASK’ approach and how to approach your RA journey.

Please visit the National Rheumatoid Arthritis Society’s webpage at for more rheumatoid arthritis specific information and support

Metoject® PEN Support Materials & Information

Side Effects

Although subcutaneous (vs. oral) methotrexate is more tolerable, very common side effects include1:

  • Stomatitis
  • Dyspepsia
  • Nausea
  • Loss of appetite
  • Abdominal pain
  • Abnormal liver function tests

Reporting Side Effects

Adverse events should be reported using the forms and information found at

Please also report any adverse events by email to medac drug safety at

Further Information & Questions


  1. Metoject® Summary of Product Characteristics. [online] Available at: Last Accessed May 2023
  2. Müller, R.B. et al. (2015). Effectiveness, tolerability, and safety of subcutaneous methotrexate in early rheumatoid arthritis: A retrospective analysis of real-world data from the St. Gallen cohort. Seminars in Arthritis and Rheumatism, 45(1), pp.28–34.
  3. Pichlmeier, U., & Heuer, K. U. (2014). Subcutaneous administration of methotrexate with a prefilled autoinjector pen results in a higher relative bioavailability compared with oral administration of methotrexate. Clinical and experimental rheumatology, 32(4), 563–571.
  4. Kromann, C.B. et al. (2014). Does switching from oral to subcutaneous administration of methotrexate influence on patient reported gastro-intestinal adverse effects? Journal of Dermatological Treatment, 26(2), pp.188–190.
  5. EU Council Directive 2010/32/EU on the prevention of sharps injuries in the hospital and healthcare sector
  6. Latex data on file
  7. Braun, J. et al. (2008). Comparison of the clinical efficacy and safety of subcutaneous versus oral administration of methotrexate in patients with active rheumatoid arthritis: results of a six-month, multicenter, randomized, double-blind, controlled, phase IV trial. Arthritis and rheumatism, 58(1), 73–81.
  8. Methotrexate and its use in rheumatoid arthritis (RA). [online] Available at: Last Accessed May 2023.
  9. Johnson, T.M. et al. (2021). Investigating changes in disease activity as a mediator of cardiovascular risk reduction with methotrexate use in rheumatoid arthritis. Annals of the Rheumatic Diseases, [online] 80(11), pp.1385–1392.
  10. O’Connor, A. et al. (2016). The rapid kinetics of optimal treatment with subcutaneous methotrexate in early inflammatory arthritis: an observational study. BMC Musculoskeletal Disorders, 17(1).
  11. Kanwar, A., Yadav, S. and Dogra, S. (2010). Psoriasis: What is new in nonbiologic systemic therapy in the era of biologics? Indian Journal of Dermatology, Venereology, and Leprology, 76(6), p.622.
  12. Warren, R.B. et al. (2017). An intensified dosing schedule of subcutaneous methotrexate in patients with moderate to severe plaque-type psoriasis (METOP): a 52 week, multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet, 389(10068), pp.528–537.
  13. Reich, K. et al. (2020). The value of subcutaneous vs. oral methotrexate: real‐world data from the German psoriasis registry PsoBest. British Journal of Dermatology, 184(4), pp.765–767.
  14. Generali, E. et al. (2021). Non-adherence and discontinuation rate for oral and parenteral methotrexate: A retrospective-cohort study in 8,952 patients with psoriatic arthritis. Journal of Translational Autoimmunity, 4, p.100113.