Methotrexate prescriptions

I have been on Methotrexate for about 12 years and recently I have started being asked by the pharmacist for my Methotrexate book. Is this a new guideline? If so I shall have to visit the doctor even more often, taking more of both our times to get it updated. Currently the doctor will only prescribe once he's seen a blood test so this would be duplication. What experience do others have? Also my hospital says I could do bimonthly tests but the gp wants monthly . Does anyone enjoy a less time consuming system?

32 Replies

  • That's strange. I have a blood test every month so they can keep an eye on it but am given my methotrexate in my repeat prescription every month with no problems. Never any issues getting it from the pharmacy. I would be curious to know as well if other people have any issues


  • I always had my blood tests monthly. I assume you are on tablet form of Methotrexate if you get them from the pharmacist. I had injections and got mine from a company called Central Homecare, my rheumy used to send them the prescription and I'd have the injections, sharps bin etc delivered. I did have a booklet to record my blood test results, this was so I could compare them month by month.

  • I have my bloods done monthly by the nurse at our GP surgery who also updates my blood monitoring book.

    No problems getting repeat prescriptions on a monthly basis, have been asked once by the pharmacist for my blue book but when I told her I didn't have it with my she said it didn't matter.

  • Yes, poemsgalore, I am on tablets. I did start initially on injections but changed to tablets about 9 years ago. I have always been expected to have monthly blood tests like everyone else (thank you for responding) but it has been the last couple of times I've collected a prescription the pharmacist has asked for the Methotrexate book. It's a nuisance because my surfers make a fuss about giving me results and I really can't fit in an appointment with the nurse to get the results as well as everything else. I had to reduce to part time to fit I. The doctors appointments and bloods tests.

  • I have my bloods done monthly, the phlebotomist enters the previous months results, I keep the book. My prescriptions are collected at the surgery dispensary

  • * surfers was surgery!

  • Thank you lab- lover. Maybe I need to significantly adjust my timing so my phlebotomist could do that. I'll ask.

  • I was able to get my surgery to email blood results when I had trouble with neutrophils or changing medication so I could keep an eye on them as the receptionists did not understand the test result I was after. I was told it was not hard to do as they received them electronically from the Hospital. The results had a normal range on them so you could tell if there was a problem. Farm

  • Thank you Farm 123. That sounds like a very good idea. I shall ask if it's possible.

  • I have a monitoring book, and when I was on the tablets the pharmacist always asked to see it, or see the latest blood test results. But I filled it in, not the GP.

    Since I've swapped over to injections the MTX comes from the hospital so they do the checks as I have 2 monthly blood tests and then get 2 month supply of MTX. I usually get a print out of my blood tests, so can add the results to monitoring book myself so I still keep it up as I find it comforting.

    I hardly ever see the GP, as now I've been on things for so many years it's all fairly automatic. So I have to take time for the blood tests, and then consultant appointments every 6 months but that's mainly it.

  • I'm pleased to hear your regime is quite straightforward, Helix. I've had to change consultant and area as we've moved quite a lot. I also had a scary blood test result once - ALT of 105 where it's usually 10 or so. Turned out to be a clerical error, but my gp hadn't picked it up. I like to know my results myself, every time! Thanks for responding.

  • can't really help on that. I have a prescribing GP. I wonder though if you could get the nurse at your doctors surgery to update your book rather than seeing the doctor every time. Maybe you could arrange to leave the book at the surgery after your blood test and pick it up again when the results are in.

  • I hand my shared care card to the phlebotomist when I have my blood test, and pick it up from the surgery a couple of days after the results come through. I think one of the admin ladies updates it.

    I initially had blood tests every two weeks, but recently moved to monthly tests. I had a rheumy clinic yesterday and my MXT was increased to 20mg - so I am back to tests every two weeks again (at least until it all settles).

    I have never been asked for any evidence by the pharmacist, but they are attached to the surgery so I suspect they know the system and that the GP won't prescribe MXT unless the blood tests are carried out.

  • hi there just wondering if you have any stomach issues after being on methotrexate for 12 years? I too get tested monthly. cheers

  • Hi yes I had this when I was on meth it is boots new thing I complained to my doctor because she wasn't very nice when I said I didn't have it on me he said that you don't have to show it get there one that they have glad I'm not on it anymore x

  • If I take 20mg (8 tablets) I feel sick for two or more days and it's unbearable. On 15 or less, with Omeprazole to protect my stomach, all I have is one dash to the loo the next day. I have to take folic acid every day except Methotrexate day to be this good, otherwise I feel sick and get stomach cramps on any dose. Hope this helps...

  • Thanks Neverwell. It was Boots and the pharmacist was quite rude, especially given she's dispensed my Methotrexate for years enough to be able to say ' and your dose has gone down, hasn't it? ' I think I'll take my card AND go elsewhere in future...

  • I have book which pharmacy looked at at first. They just confirming I have blood tests done to cover themselves v

  • Good morning,this has concerned me,as I have never been asked for my monitoring book ever !!,I have monthly blood tests,so I assume,if there's anything wrong they would just ring you think I should ask for this? I go to my GPS for my blood test thanks

  • Why not ask the pharmacist why he/she is doing this? Possibly they have had repeat prescriptions coming in where blood monitoring is not being done?

    I can't have my repeat prescription until i have had the blood test. But I don't have my book filled in ever. When I asked for it to be filled in at the beginning I was told it would hold up the clinic too much. I can't get my results either unless I see the doctor - I find this very irritating and don't like having to rely on them to phone me if there is a problem (although to be fair they always have done)

  • Oldtimer I may well ask the pharmacist if I ever darken Boots door again, but she bit the head off her assistant for not labelling something properly seconds before she told me I must have the book next time! I understand they have procedures to follow but like many of you I am not given a prescription until the monthly blood test result is back at the surgery.

  • Shell1967 - don't be worried - I was given the prescription way and I suspect this is a London or even East London problem. It only seems to apply to Boots, too.

  • Definitely an East London thing. I can't get my prescription until my red book has been updated, and then the Boots pharmacist asks to see the book before dispensing.

  • I have blood work done every month. I haven't had a problem with any organs. But I wouldn't feel comfortable without having lab work so I know all my organs are okay.

  • Abby11. I don't think anyone would complain about having monthly blood tests. The issue for me is that I can only get a prescription when the results are in and healthy BUT my pharmacist seems to think they need to check too. I trust all the doctors I see to make sure my liver and kidneys are fine before they give me a prescription. It seems a bit much that the pharmacist has to check too. If my bloods were showing something wrong I wouldn't be given a prescription. That is quite right and reassuring.

    At the end of the day having a chronic condition means spending far more of a life than anyone wants waiting in doctors, phlebotomists, other therapist and pharmacists waiting rooms. So far I have spent 5 hours this week just waiting. Going back to my gp again to get the book filled in or a printout (for which they charge me) seems a step too far. Rant over! Oops sorry!

  • This is worrying me now - you all seem to have monthly blood tests. I was only diagnosed 2 years ago, so not that long really. I am on 25mg mtx by injection. I dont have a book anymore (only had one when on tablets), my GP refused to fill it in last time I asked him (when still on tablets). I also dont get told when to go for blood tests - went today because it had been 3 months and I was feeling absolutely awful with mouth ulcers and swollen tonsils etc. I saw my Rheumatologist in December and was told not to come back for a year, when my injections run out they just send me more - no one seems to care about blood tests for me :-(

  • I think your situation is unusual. I had regular blood tests when I was on MTX injections. I just had one every time I picked up my injections in those days. Every 3 months I think..

  • I changed to two monthly blood test just over a year ago because my bloods had been stable for a long time. I was told by the specialist nurse when I first started taking MTX that my GP should not prescribe MTX until he had checked that I was having my bloods done when I should and that the chemist would also ask to see my booklet before they would hand over the drugs to double check. I have never been asked at the chemist for my booklet.

    I don't even think that the doctor checked my bloods because I once had a note attached to my repeat prescription asking me to contact the surgery to verify that I was having my bloods done. I always have my bloods down when I should.

    I have my bloods done at the hospital and I always hand them my booklet and they put in the previous results in it for me.

    I did get a letter once from my GP's saying that if I didn't change to having my bloods done at their surgery they would not prescribe me anymore MTX. I was annoyed about this, I thought it was blackmail...what happened to patient choice? I prefer to go to the hospital for my tests, it is nearer than the doctors surgery and on the odd occasion that I have had a problem I have always managed to see one of the specialist nurses when having bloods taken.

    I got the last laugh....I had just started injecting MTX at that time so the hospital does the prescriptions now and not the GP.

    Paula x

  • Well done, Paula!

  • e r meant to show our updated booklet every time u have a new prescription but i have never had mine updated or had to show it appart from the first time. Think its to make sure there are no mistakes

  • Hi Susan

    Each GP, hospital, pharmacy etc seems to do their own thing. I am on 15mg of methotrexate by injection, and I attend 6 weekly for blood tests at my Doctors. However I have to travel 6 miles to hospital to pick up my prescription. I also have to show my book. The pharmacy mainly check to see the dose I am on rather than the latest blood test results are up to date. Check with your pharmacy to see why they need you book and maybe they can help you come up with a suitable solution. Good luck.

  • I've been on methertraxate for as long as I can remember repeat prescription recently no tablets in my prescription I phoned the doctor to be told no blood test no tabs  

    Took over a week until I got my blood done and got my methertraxate 

    Same thing has happened again today should my doctor of nearly 30 years arrange my bloods as he has always done or is it up to me now to arrange to get my bloods done or remind my doctors I need to know what's changed and should I have been informed thanks 

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