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Severe injection site reactions : Mild soreness is normal, but increasing pain, significant swelling, or signs of infection (redness, warmth, discharge) require medical review

Studies of oral versus subcutaneous methotrexate in patients with RA suggest that the subcutaneous formulation results in a linear increase in systemic exposure greater than oral methotrexate at doses greater than 15mg per week and did not result in any unexpected adverse effects

Its primary mechanism involves activating the AMP-activated protein kinase (AMPK) pathway

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