Minimising methotrexate dosing mix-ups

CLEAR and precise information is necessary when prescribing low-dose methotrexate to be taken once weekly for autoimmune or inflammatory conditions.

Minimise the risk of patient confusion, and the potential for a subsequent overdose, by:

- clearly stating that methotrexate is only taken once a week and should never be taken more often than once a week

- asking the patient which day of the week it would be most convenient, or easiest for them to remember, to take their once a week dose

- confirming the day on which they should take their dose (e.g. “Always take your dose on Tuesdays”)

- providing clear verbal and written instructions on the dose, and the day and time of administration; avoid abbreviations when writing down dose instructions

- informing them that taking extra or irregular doses is dangerous and that they should not take a catch up dose if they miss a dose

- asking them to inform