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Methotrexate patient-held record — GPhC CRA MCQ

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ModeratePatient Counselling and Pharmaceutical CareMethotrexate patient-held recordGPhC CRA

A patient collecting methotrexate tablets says she has forgotten which day she takes them and has no monitoring booklet with her. What would you advise the patient?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Clarify the weekly dosing day before supply and reinforce monitoring and toxicity advice

Methotrexate weekly dosing errors can be fatal, so the dosing day should be clear before supply. The pharmacist should reinforce the monitoring schedule, folic acid instructions and warning symptoms such as mouth ulcers or sore throat. Patient-held records can support safe use. 'As directed' without counselling is unsafe where the patient is uncertain.

Reference: BNF; MHRA; NPSA legacy guidance