GP sanctioned for incorrect prescribing

A West Australian GP who prescribed toxic levels of methotrexate to a patient who later died has been ordered to complete courses in medication safety, proper note-taking and the diagnosis of rheumatoid arthritis.

A tribunal heard that the patient, a middle-aged Indonesian national, presented with stiffness and soreness in his joints, and disclosed a past medical history consistent with rheumatoid arthritis and urinary tract infections.

After measuring his blood pressure and heart rate, Dr Dian Haryaty Harun prescribed methotrexate (10mg, one tablet daily) and wrote instructions to take half a tablet (5mg) daily for five days, then one tablet (10mg) daily for seven days.

This is about three-and-a-half times more than the recommended adult weekly methotrexate dose of around 20mg.

According to an agreed statement of facts, the male patient experienced diarrhoea, vomiting, excessive urination and mouth