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Methotrexate counselling — GPhC CRA MCQ

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EasyPatient Counselling and Pharmaceutical CareMethotrexate counsellingGPhC CRA

A 56-year-old man with rheumatoid arthritis collects methotrexate 15 mg tablets to take weekly and folic acid 5 mg. He says he plans to take methotrexate Monday to Friday because the dose is high. What would you advise the patient?

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

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Correct answer: C — Take methotrexate once weekly on the agreed day and seek help for mouth ulcers or breathlessness

Methotrexate for rheumatoid arthritis is taken once weekly and dosing errors can be fatal. The patient’s intended daily dosing indicates an immediate counselling and safety intervention. Folic acid is usually taken on a separate schedule according to the prescriber’s instructions, not as a substitute for safe methotrexate dosing. Key toxicity warnings include mouth ulcers, sore throat, unexplained bruising and breathlessness.

Reference: BNF; MEP