Important Update: New Methotrexate Safety Measures and Patient Information
To significantly enhance patient safety, the Buckinghamshire, Oxfordshire, and Berkshire West Integrated Care System (BOB ICS) has issued a new position statement regarding oral methotrexate 10mg tablets.
Effective May 2025, oral methotrexate 10mg tablets are classified as “non-formulary (BLOCK)” and are no longer to be prescribed and dispensed routinely. This is a critical patient safety measure in response to serious medication errors, including local accidental overdoses, caused by the availability of both 2.5mg and 10mg strengths.
Key Prescribing, Dispensing and Safety Requirements:
- Prescribing Standard: All prescribers are now mandated to only prescribe methotrexate in multiples of the 2.5mg tablet, clearly stating the total weekly dose.
- Pharmacy Action: Should not dispense 10mg tablets after May 2025, see the statement for further dispensing recommendations.
- BOB ICB are aware of a small cohort of patients where the continued prescribing of oral methotrexate 10 mg has been carefully considered by the prescriber and patient; however, we suggest in the first instance you challenge any prescription for the 10 mg strength and document the outcome within your clinical system to ensure this is captured for future reference.
- Patient Education: Utilise the new “Methotrexate Patient Information Leaflet“ to support the transition and emphasise the crucial once-weekly dose.
- New Policy: The Methotrexate Shared Care Protocol is now available to clarify roles in patient monitoring and management. Please familiarise yourself with this document.
Your vigilance in adhering to the oral methotrexate 2.5mg-only dispensing standard is vital for preventing patient harm.
This comprehensive approach ensures informed patient care and improved safety.
