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Methotrexate weekly dosing — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsMethotrexate weekly dosingGPhC CRA

A patient presents a new prescription for methotrexate 10 mg daily for rheumatoid arthritis. The PMR shows previous methotrexate 10 mg once weekly with folic acid on a different day. What is the most appropriate action?

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Correct answer: C — Do not dispense until the prescriber confirms the intended frequency

Methotrexate for rheumatoid arthritis is normally taken once weekly, and daily dosing can cause fatal toxicity. A prescription written as daily should be treated as a high-risk discrepancy and clarified with the prescriber. The pharmacist should not unilaterally change the legal prescription without resolving the error. Folic acid is usually taken on a different day according to the prescribed regimen.

Reference: BNF; MHRA Drug Safety Update