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Methotrexate counselling — GPhC CRA MCQ

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HardPatient Counselling and Pharmaceutical CareMethotrexate counsellingGPhC CRA

A patient with psoriasis collects methotrexate 2.5mg tablets, dose 15mg once weekly, and folic acid 5mg once weekly on a different day. The patient says the tablets are small and asks whether taking one daily would be easier to remember. What would you advise the patient?

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

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Correct answer: D — Take methotrexate once weekly on the agreed day and seek help for mouth ulcers or sore throat

Methotrexate for inflammatory disease is taken once weekly; daily use can cause life-threatening toxicity. Counselling should reinforce the weekly day, folic acid schedule, monitoring and toxicity symptoms such as mouth ulcers, sore throat or unexplained bruising. Trimethoprim should be avoided unless a prescriber has considered the interaction. Blood test monitoring remains important even if symptoms improve.

Reference: BNF Methotrexate; MHRA/NPSA methotrexate safety