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Methotrexate weekly dosing — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsMethotrexate weekly dosingGPhC CRA

A 52-year-old woman presents a new prescription for methotrexate 15mg tablets and folic acid 5mg for rheumatoid arthritis. The methotrexate directions state 'take as directed' and she thinks it is a daily medicine. What is the legal classification/requirement?

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Correct answer: DClarify and label methotrexate with explicit once-weekly dosing before supply

Methotrexate dosing errors can be fatal, and weekly dosing must be made explicit. Ambiguous directions should be clarified with the prescriber and the dispensing label should clearly state the weekly dose and day where possible. Folic acid is commonly used to reduce adverse effects according to the prescribed regimen. The patient's misunderstanding is a major safety signal.

Reference: BNF; NPSA/MHRA methotrexate safety advice