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Methotrexate weekly dosing — GPhC CRA MCQ

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EasyMusculoskeletal TherapeuticsMethotrexate weekly dosingGPhC CRA

A patient with rheumatoid arthritis presents a new prescription for methotrexate 10 mg tablets, one tablet daily. The patient says the rheumatology clinic told him it was a weekly medicine. Folic acid is also prescribed weekly. What is the most appropriate action?

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Correct answer: C — Withhold supply and urgently clarify the methotrexate directions

Low-dose methotrexate for rheumatoid arthritis is normally taken once weekly, and daily dosing errors can be fatal. The mismatch between patient understanding and prescription directions is a serious safety concern. The pharmacist must clarify before supply and ensure clear counselling and labelling.

Reference: BNF; NPSA safety guidance