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DMARD infection advice — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsDMARD infection adviceGPhC CRA

A patient taking weekly methotrexate and adalimumab has fever 38.4°C, productive cough, breathlessness and respiratory rate 24/min. What should the pharmacist advise?

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Correct answer: BWithhold methotrexate and adalimumab; arrange urgent infection assessment

The patient may have a serious infection and is immunosuppressed. Urgent clinical assessment is required, with further methotrexate and adalimumab doses withheld until the treating team advises restart. Continuing either immunosuppressant or delaying assessment is unsafe; trimethoprim also interacts dangerously with methotrexate.

Reference: BNF: methotrexate: https://bnf.nice.org.uk/drugs/methotrexate/