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Methotrexate labelling — GPhC CRA MCQ

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ModerateDispensing and SupplyMethotrexate labellingGPhC CRA

A repeat prescription for methotrexate 2.5mg tablets states 'take six tablets once weekly on Mondays'. The patient also receives folic acid 5mg once weekly on Fridays. What is the legal classification/requirement?

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

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Correct answer: D — Dispense with clear weekly dosing and counselling to avoid daily methotrexate use

Clear labelling is essential for methotrexate because daily use in error can be fatal. The prescribed weekly day should be retained and the patient counselled, especially at repeat supply if there is any uncertainty. Folic acid instructions should also be clear and distinct. The pharmacist should not alter the regimen in a way that creates daily methotrexate exposure.

Reference: BNF; MEP