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Methotrexate toxicity counselling — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsMethotrexate toxicity counsellingGPhC CRA

A patient taking methotrexate 15 mg once weekly asks which new symptoms require urgent advice between blood tests. Which cluster is most important?

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

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Correct answer: AMouth ulcers, sore throat, unexplained bruising or new breathlessness

Mouth ulceration and sore throat can precede severe marrow toxicity, bruising can indicate cytopenia and new breathlessness can signal pneumonitis or infection. These warrant prompt assessment even if recent monitoring was normal; weekly dosing and interaction checks remain essential.

Reference: BNF: methotrexate: https://bnf.nice.org.uk/drugs/methotrexate/