I took methotrexate in the early 2000s and had a remission. When I started having pain again I went back on and gave myself injections. I developed mouth sores and my dentist told me to swish Listerine around in my mouth for a full minute every day. That worked well. Then my rheumatologist died and in my Montana town there was no other rheumatologist. After no DMARDs for 10 years I returned to MN and am now back on methotrexate. I am self-injecting 20 mg once a week with a tiny insulin syringe and so far have had no side effects. One swollen finger is beginning to bend again. I've always been aware of the side effects. Occasionally I feel a bit dizzy after the injection so I do it in the evening when I can sleep it off. I hope this works since the next step would be a biologic.