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Oral methotrexate is a safe and effective medication if taken at the right dose

and with appropriate monitoring. However, the NPSA’s patient safety alert highlighted very occasional problems with taking the medication that resulted in serious harm and even death.

As a result, all NHS organisations (including NHS foundation trusts) should take the

following steps:

1. Ensure that actions recommended in the NPSA alerts are completed including local self-assessments to check compliance to the patient safety alert.

2. Give patients who are taking oral methotrexate the core patient information leaflet and monitoring document. These have been reviewed in collaboration with the British Society for Rheumatology (BSR) and the British Association of Dermatologists (BAD), both of whom support the content

and their being issued to patients.

In East Lancashire Hospital Trust all patients being started on Methotrexate will be issued with a Methotrexate Drug Monitoring Booklet (see below) which will be used to record the monthly results of blood monitoring and any changes made to the dosage instructions.