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Methotrexate toxicity counselling — GPhC CRA MCQ

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EasyPatient Counselling and Pharmaceutical CareMethotrexate toxicity counsellingGPhC CRA

A patient collecting methotrexate 2.5mg tablets for psoriasis says they took one tablet every morning last week because the pain was worse. They now have mouth ulcers and feel feverish. What is the most appropriate action?

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Correct answer: B — Refer urgently for suspected methotrexate toxicity and contact the prescriber

Daily methotrexate dosing in error can cause severe toxicity. Mouth ulcers and fever may indicate bone marrow suppression or infection and require urgent assessment. The prescriber or specialist team should be contacted and further doses withheld pending advice. Symptomatic treatment alone would be unsafe.

Reference: BNF; MHRA methotrexate safety advice