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Methotrexate weekly dosing — GPhC CRA MCQ

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EasyMusculoskeletal TherapeuticsMethotrexate weekly dosingGPhC CRA

A prescription for methotrexate 10mg daily is received for a patient with rheumatoid arthritis who usually takes 10mg once weekly on Mondays. The patient also takes folic acid once weekly. What is the most appropriate action?

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

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Correct answer: E — Query the prescription urgently before supply

Methotrexate for rheumatoid arthritis is usually taken once weekly. A daily instruction could cause fatal toxicity, so the prescription must be queried urgently. The pharmacist should not silently alter a legal prescription without appropriate authority and communication. Clear weekly labelling and counselling are essential.

Reference: BNF; NICE CKS