What gap do you leave between blood tests?

Hi everyone

I wonder whether anyone goes more than a month between bloods for MTX?

I've been on it nearly a year and now up to 22.5mg. Bloods have always been ok although they've jumped around a bit.

If I go four weeks it will cut right through my summer and I would love to just forget about all that for a while...

What do you think? Could I go six weeks?



21 Replies

  • It depends on your Hospital and their guidelines. Not MTX but when I was on leflunomide, the rules were rigid and they couldn't/wouldn't issue my medication without 4 weekly bloods.

    After some years on MTX, I fought my corner and rheum agreed to stretch to 8 weekly but the prescribers have a professional responsibility and I understand why they don't always want to deviate. I just couldn't manage it with work and my clinic stopped doing walk-in bloods, it was such a hassle.

  • I've been on MXT for 2 years without problems and I now have 3 monthly bloods. It seems they keep you on monthly until they feel there won't be any problems, but even then a couple of weeks over shouldn't make a difference I would have thought. I did this a couple of times when I went on holiday.

  • Talk to your rheumy team, as it's really their decision as to what's safe for you. I now have blood tests every 3 months, but then I've been on my cocktail of drugs for over 6 years now with no real problems.

  • I've just dropped down from having fortnightly bloods to monthly as my liver function has finally settled down after being high for approx 18 months. It was my rheumatology team that decided this. I think it would be a good idea to discuss it with your team xXx.

  • I think my hospital's guidelines are pretty standard.... fortnightly bloods for 6 weeks for any new DMARD, unless there are erroneous results, then for MTX, SSZ & LEF monthly. Your hospital may have different ideas but I would think if you normally have monthly bloods then they're being diligent. You could ask but l wouldn't be surprised if they wished you to continue as you have been doing, especially if they've not usually been mid range. It is very much up to your Rheumy though. I admit I found monthly bloods a bit ott once I'd settled back into my meds when I came back to the UK as I only had them done every 3 months previously.

  • I have been on it for months and still have bloods done weekly. Not aware of any significant issue

  • Ihave been on it for longer than i can remember still monthly

  • Thank you all for your responses. Seems there is big variation in terms of what different hospitals expect. Typical! Guess it will come down to what my rheumatology nurses think, but it is so very useful to get a sense of what others do. Thanks you as always.


  • Is it that you have to travel a distance to your hospital to have bloods done Bon, & this is what will cut right through your summer? If so could you request they're done at your Surgery, if it's as it is for many of us & nearer to home? I try to book them early doors then there's no backlog, it means I'm in & out in 15 mins normally.

  • I have been on it for 6 years and now do every two months BUT this was by recommendation from my rheumy as I had no issues. If my results blip then I have to do a few weekly ones again. To be honest it only takes me about 1.5 hrs to get to the surgery, bloods then back again so monthly wasn't too much of a pain for me.

  • Hi, I choose to get mine done monthly-6 weekly. I like to keep an eye on everything myself and so ask for them to be printed out. I live as 'normal' a life as I can: work full-time, have a drink occasionally, go out and about (when I have any energy left) and so check my bloods are behaving. If their not, I adjust my activities accordingly. If I have any concerns, I make a GP appointment to discuss it. I've found that I have to be proactive as neither the GP nor the rheumatologist can read my mind or predict my future 😁

  • I have been on mtx (17.5 mg) for over a year and was told by my rheumy at the last appointment in March that I could have blood tests every 6 rather than 4 weeks. My blood tests have always been fine and my inflammation is low atm - I assume if that changes I may have to have blood tests more frequently again.

  • Usually to start your needing bloods taken each week normally after 6 weeks if everything's ok they lengthen usually every 4 weeks. After after a while if bloods are stable again gap is lengthen. This is normally done if bloods are stable. Also each hospital are different. but need to follow guide lines. If your on holiday have bloods taken just before.

  • I believe there are minimum guidelines, and if you are settled then the rheumy can extend the period if they have no concerns.

    I was ok for the first 18 months and went out to every 2 months - just as I was about to go to 3 months my liver had other ideas!

    I went back to 2 weeks, then 4 weeks again. Saw my rheumy last month and I can now go to 6 weeks as long as my liver doesn't wobble too much!

    It's a nuisance getting it done, but I look at is as it is for my benefit - it's easier to control if fluctuations or problems are picked up at the earliest opportunity.

    Besides all that - I know the nurse well now, and we have great chats!!

  • Every 4 weeks. Been on MTX for 3 years but also on a biological which I have via IV every 4 weeks. Bloods are taken on a Monday results reviewed and infusion is prepared on wed then delivered to my hospital Thursday am.

  • In Ireland the protocol is every 3 months. I'm on 25 mg of MTX and get my bloods done every 3 months.

    Having said that, the more I read this site the more I realise how different (and sadly not in a good way) the Irish system is to the UK.

    Without doubt the best approach is to talk to your rheumy. If he / she is happy with your results to date, chances are there won't be a problem. But good to ask for your own peace of mind.

  • I've been on mtx for about ten years and I'm now up to bloods every three months. I do have occasional poor results and then I go more frequently.

  • Hi Bon1, I used to have a blood Test every month but since seeing my Rheumy last time it's now every 3 months so much easier on the arm.

  • Ask your doctor for her kind lines for it is up to her how often the text she orders needs to be run. Because to mex plays havoc on the liver, this need to be watched. This way they can catch if the values go up quickly so no damage is done

    I have mine done every 9 weeks like clock work per doctors standing orders.

  • I am supposed to go three months without a blood test .was taking 15 mgs,a week but be stopped, now going on three weeks due to bad side effects and the fact that I had to go for so long without a blood test.

    I was about to start a new thread, because I think I'm having a flare. I'm wondering if it has to do with tapering ( just finished week one of DSNS 7/6.) or the lack of mtx. I had been on 7.5 for three weeks and managing fine, except for the mtx side effects.I saw this thread which seems relevant.


  • Hi Gaijin

    Sorry but I don't know what DSNS is. In terms of the blood tests - the general consensus seems to be that when you first start on MTX the blood tests are pretty frequent. Was the plan for you to be three monthly from the very beginning?


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