When I was early into my RA diagnosis, I used methotrexate. I began using pills. I had lots of issues with nausea and general yuck!!! Poor appetite and exhaustion. I switched over to the injectable methotrexate to see if it would reduce nausea, the yuck, stomach pain, etc. I am not one who is afraid of needles, but I was a bit nervous about the injections. But, you use a small needle and you learn the most effective way for you. Unfortunately, it did not work as well as we had hoped and I moved to biologics.