Frequency of blood tests when on methotrexate? - NRAS


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Frequency of blood tests when on methotrexate?

cazh profile image

Our local GPs have decided that everyone on mtx only needs to have blood tests every 3 months. Up till now, I've been having tests every month. Now while I'm more than happy not to have to go every month, I'd have thought it should have been a decision for each patient's consultant. Just wondered how often others were tested?

Hope everyone's as well as can be.

26 Replies


Our area regards blood tests

At this time I have mine every two weeks, this will extend to three weeks after taking medications for three months.

Eventually my blood tests will go to one every month, with a visit to the RA Nurse every 3 months. I see the Specialist every six months for a check up, I suppose that will be extended to twelve months if they stop the medication. This will then be for scans and blood tests My age is sixty three and can have severe contraindications.

Good Luck


Thanks for quick reply. Sounds like you're being carefully monitored.

Hi, I have blood tests every month and have had for years! My Mum (who also has RA but lives in another county to me) was having blood tests every 8 weeks until her recent flare so she is back on every month until her bloods are better. Both timescales were set by the rheumatologists not the GP. Kind regards.

cazh profile image
cazh in reply to Pands

Thanks for this info.

I have mine every month and think it down to you rhuemy nurse or consultant not down to your gp

Hi just had a call from my gp I need more monitoring! Must be a new protocol out ha ha xxxx

cazh profile image
cazh in reply to allanah

I was just thinking ours might be something to do with saving money - or is that too cynical?

allanah profile image
allanah in reply to cazh

Lol ! Us cynical and sarcStic? Hell yeah ha ha xx

I started weekly, then two week, then monthly, then 6 weeks and I am now every two months, having got let off for good behaviour. Interestingly this is very much a UK approach, as the French rheumy I went to see said once every 6 months was fine once you had got used to the drugs.

it depends on whether your ra is under control or not...when it is tests are normally every 8 wks but more frequent if flaring

Once medics feel you are `settled' with your medications ie they are working, blood tests revert to every 3 months. If for any reason your situations changes or your meds change then they would probably test more frequently.

Iv had RA for 7 years, my blood tests used to be every week then slowly got further apart, I now only go for blood tests every 8 weeks unless they have a concern then they will be every two weeks

Mine is monthly, has been since diagnosed and on mxt for 4 years

Thanks for all the replies, seems like as with everything to do with RA, there is so much variability with tests.

Your NHS region will have what they call a "shared care" protocol for managing and monitoring DMARDS. See if you can get hold of a copy. It should lay down exactly what the GP is meant to do (about prescribing, and about monitoring) and when to refer back to the rheumatologist. Three monthly tests may be fine if you have been having tests more frequently, are stabilised on the dose, and haven't had any problems with it since being stabilised. It sounds a bit too short if you are fairly new to it, or haven't been on the current dose for long.

This link is an example from the northamptonshire guidelines, but each area is slightly different, so you need to find the document for your area. Try googling "shared care DMARD" with the name of your NHS region to find them.

in reply to earthwitch

I don't have a shared care protocol, mine all come from hospital pharmacy but still, my GP often comments that I should have bloods every month (on injected MTX and lef, waiting for new anti TNF). My rheum says every 8 weeks, so I try to humour both and go for 6 weeks! ;) I've been stable on the dose for a couple of years though.

cazh profile image
cazh in reply to earthwitch

Thanks, will see if I can find this.

I have been stable for the last 2 years and was switched from monthly to 2 monthly injections. I would be very reluctant to go any longer than that . In fact, my GP told me he would be unhappy for his patients to go more than 2 months between blood tests.

I am on monthly blood tests with methotrexate. Have been for 2 years.

I have been on methotrexate for 7 years and get tested every month. cheers

I've been changed to 3 monthly now. Used to be monthly last one was Jan so due in April. My R A is manageable at the moment and bloods stable maybe the is why I've been changed x

My tests were initially every 6 weeks. Then when it appeared I was in remission, they were extended to every 3 months. I was diagnosed January 2012 and am on MTX, Humira and Meloxicam (NSAID).

cazh profile image
cazh in reply to Karen77

Thanks for this. Good to hear you're in remission.

Karen77 profile image
Karen77 in reply to cazh

Well, not quite. My symptoms actually started returning in November and seem to be sticking around... but my old rheumy retired (old as in former AND elderly, ha!) and my new rheumy is maintaining the same schedule (for now at least).

At first mine were every two weeks but that was as my RA was quite out of control but then it got to a month then two months then three once MTX started to work and the bloods were steady.

Been diagnosed 4+ yrs. RA still not under control. Have 4 wkly bloods. Maximum at my clinic is 2 mths

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