Changes in Provincial Coverage for Injectable Methotrexate

Methotrexate can be used as a disease modifying agent for many conditions, from inflammatory arthritis to psoriasis to inflammatory bowel disease.  In our past blogs, we have written about many strategies for managing its adverse effects.  Injectable methotrexate is preferred over tablets as it is better absorbed and has less nausea, yet government coverage for the injectable form has been for the 25mg/ml vials. Drawing up a dose out of a vial can be difficult for arthritic hands.

A pre-filled syringe is now being covered by government sponsored plans (ODB, Trillium, ODSP) which is a higher concentration than the methotrexate supplied in vials. This means that the same dose is now provided in half the volume (i.e. 20 mg is in 0.4ml of liquid vs 0.8ml in the vial format) and the pre-filled syringe is much easier to administer. Syringes are available in 17.5mg, 20mg, 22.5mg and 25mg strengths.  We are happy to answer your questions about this dosage form of methotrexate.


Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

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