Methotrexate- packaging: Hello.. A completely random... - NRAS

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Methotrexate- packaging

TheBoys profile image
34 Replies

Hello..

A completely random question here.. i went online to get a new prescription for methotrexate this week. I also saw my consultant who gave me a steroid injection for my knee.

My partner picked up my tablets and first thing that struck me was that i was only given twelve so my gp has given me one months supply. But - the tablets are loose and in a bottle, no info leaflet. Is this normal or am i being stupid?

The dosage will only last three weeks as the consultant upped me to four 2.5 tabs so i need to address this as well but was concerned that someone has now handled tablets. Am i mad?

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TheBoys
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34 Replies
JFlay profile image
JFlay

Hi, it can be normal to have tablets dispensed into a bottle (it always used to be done like that when I was young 😂) I had some recently done like that, it depends where the chemist gets the supply from. They never 'handle' tablets in a pharmacy so should be no worries there.

How often do you have a blood test ? I’m only given enough until my next blood test. I’m not happy with chemists who put tabs in bottles

A) there’s no information

B) the bottles are difficult to open

C) they put my methotrexate and folic acid in identical bottles and I made a mistake taking the wrong meds.

D) twice they didn’t put enough tabs in and I had to go back and each time they questioned me. The third time I counted them out in front of pharmacist on collection again short.

Needless to say I don’t use them anymore.

Check with your surgery as to why only one months supply.

TheBoys profile image
TheBoys in reply to

Hi there

I ve been havingblood tests every two weeks and no issues thus far. Also had Lung CTs, ECG and Echo Cardiogram ..to ensure i was fit and healthy to take the Methotrexate.

I feel morw comfortable with tablets in a blister pack and seeing the information leaflet. I know its a decent pharmacy but am wary that someone has handled the tablets before me..plus a bottle isnt a sterile environment. It doesn't take much to worry me lol!

in reply to TheBoys

I’m the same🤣😂

TheBoys profile image
TheBoys in reply to

Lol

helixhelix profile image
helixhelix in reply to TheBoys

Pharmacist have strict protocols, the bottles are single use and sterile and tablets are counted by a machine not sticky fingers. Don't worry.

TheBoys profile image
TheBoys in reply to helixhelix

Thanks for that..paul

in reply to TheBoys

I wish I got mine in a bottle as getting them out of blister packs reall hurts.

KittyJ profile image
KittyJ

Sometimes mine are in blister packs and sometimes loose in a bottle. It doesn’t bother me really apart from the blister packs are difficult to get the tiny tablets out of. My pharmacy puts an ordinary top on the bottle so I can undo it easier. I used to work in a pharmacy and never saw them ‘handle’ the tablets😊

TheBoys profile image
TheBoys in reply to KittyJ

Tnx for that, Paul

Gigi71 profile image
Gigi71

I have been taking mtx for 3 years and only get one months supply at a time. Sometimes blister packs and other times loose in a bottle, maybe my imagination, but I seem better on the small tabs in the blister packs. X

StormySeas profile image
StormySeas

It’s highly irregular to dispense medication without a patient information leaflet (PIL) and it’s against the pharmacist’s code of conduct. Quite rightly - it’s a very serious offense and it can lead to disciplinary action.

I’d complain to the pharmacy. They’re just being lazy as all they had to do was photocopy a PIL and hand that out with the drugs. I wouldn’t worry about the tablets being handled as they have procedures t to ensure this doesn’t happen, but the lack of a PIL is really bad.

They might say they know you’ve had this drug before, but that is no excuse. It’s essential that patients have access to important information about their drugs, particularly ones like MTX which can have serious side effects.

Not everyone has access to the internet (or the ability to gain access in an emergency) and a PIL is the only way to ensure patients’ safety...

AgedCrone profile image
AgedCrone

I always had my Mtx in a bottle for 7 years. Mtx doses are often upped & downed so until your rheumy thinks you are well settled on a drug they are often dispensed this way.....it saves waste.

If you have had Mtx before you should have been given a PIL then.If you feel you need another one just ask your pharmacist.

But don’t worry - they haven’t been handled, they are tipped from a container of hundreds & counted on a measuring tray & tipped straight into a sterile bottle. Your next scrip will probably be upped as your GP doesn’t up the prescription until the Consultant writes to tell him he has increased the dose.

If you are only on 10mg per week...it is quite likely your dose will be upped...so then you’d get more tablets each month.

If you think about it .....there is no point dispensing too many tablets....if you then change meds, once drugs have left the pharmacy they cannot be put back in stock...they have to be destroyed.....waste again!

Plus as we all know..,trying to get more than one month’s supply of most drugs is nigh on impossible!

jomojo profile image
jomojo

I have recently been given my methotrexate in a bottle rather than a blister pack and the tablets are larger with no identifying marks on.

The hospital always gave me 3 months worth too. GP 4 weeks only.

All about money and suppliers availbility. I much prefer the blisterpack.

TheBoys profile image
TheBoys in reply to jomojo

Thanks for that. I cant put my finger on it but i do feel safer with the blister. No confusion for me with them in this format. Its a strong drug that needs respect. I m going to raise my concern with the GP regardless.

Hocuspocus123s profile image
Hocuspocus123s

Yes they put in a bottle and I always have problems getting it from my Dr. My consultant put up my dose to 8 tablets every week and unless my gp sees the blood results regular she won’t keep me up to date so I’m always pestering them and it’s a nightmare and stressful. Good luck.

TheBoys profile image
TheBoys

Its another pain in the backside you dont need isnt it all this chasing to and fro. I end up stressing on it. My consultant told me to take four but that hasnt caught up with the GP yet. So my 12 tablets will last three weeks not four and it ll be a scuffle getting a repeat prescription. Good job i got a prepaid prescription as at nearly £9 a throw this becomes a expensive experience

StormySeas profile image
StormySeas

Forgot to say my GP practice has become much stricter about my supply of MTX, I think the guidelines might have changed. Only ever a month’s supply now. Like you my dose changed and it was hard to get my prescription upped to reflect it - it requires a Dr to authorise so I’d start in good time so you don’t run out....

TheBoys profile image
TheBoys in reply to StormySeas

I know that in Rep of I their guidance is very strict and a months supply is adhered to.

Bradclew profile image
Bradclew

No you aren’t mad Methotrexate has strong security around it i get mine delivered from a proper drug place attached to the NHS

Coming loose in a bottle doesn’t seem right you need to ask the appropriate questions of your Dr before taking them

.

Nuttyshirlz profile image
Nuttyshirlz

Hi I always get mine like that with just my name on bottle or box. Also only given 3 weeks at a time always have. Did get a print out of the pills when first started couple of years ago.my boots Pharmacy I use is really good she always asks how I’m coping etc. She loves to talk about all my pills. Pharmacy no more about your pills than your Gp does. I really wouldn’t worry. 🙂

TheBoys profile image
TheBoys

I might change my pharmacy then. I dunno bout other people but my first reaction was to open the bottle and count them

Needlesss to say, one rolled off the worktop onto the floor.

Well now, that's where I fell out with my pharmacist, short term...same as you, bottle with no information leaflet, but with Sulf.

I calmly pointed out his legal obligation and pointed out his silliness in leaving himself open to either the wrath of his governing body or of a judge...or both.

Next bottle looked to be the same, but on inspection actually contained required leaflet, which was adhered to the patient label.

Naturly, I thanked him and we are cool.

As he explained, he'd mistakenly thought I'd memorised relevant details, since that was my second time on the drug, which allowed me the opportunity to bring up the topic of brain fog, leading to me being given a dosette box with leaflets attatched.

Winner-winner, quorn dinner! :)

in reply to dembonesDAMNBONES

Quorn🤮🤢

dembonesDAMNBONES profile image
dembonesDAMNBONES in reply to

Prolly my phone, but looks like you've sent me two empty boxes, coffin-shaped, no less! :)

I'm hoping they're smilies. Lol.

Tibatha profile image
Tibatha

No you have to.be observant

Pulfs profile image
Pulfs

I switched to methotrexate injections feel much better on them. When on tabs they were always dispensed loose in a bottle 3 to 4 wks supply but I did ask for an easy screw top not a secure one. I also put all my meds in a weekly dispense so they are easy to take. Don't worry about the bottle as has been said it's sterile. X

Pawz4me profile image
Pawz4me

I'm in the U.S., and methotrexate is always dispensed loose in a bottle. I had no idea it even came in blister packs! I would hate that, as I despise trying to get pills out of those. The lids on our prescription bottles here can be flipped over. The pharmacy gives them to you with the childproof side engaged, but you can flip the lid upside down and it screws on with a wide "lip". It makes getting the bottle open a lot easier.

Dan13rheumatoid profile image
Dan13rheumatoid

I have had methotrexate in bottles also several different brands mixed up. Maybe pharmacy was getting rid of old stock I now go elsewhere.

TheBoys profile image
TheBoys in reply to Dan13rheumatoid

Crikey

.theres a thought

Sallysuk profile image
Sallysuk

Methotrexate is supplied to pharmacies either in blister packs or loose depending on company. The tablets are electronically counted then dispensed in clean( not sterile) bottles and labelled with name /strength of drug/quantity/directions on how to take/date of dispensing and any approved warnings. A pil should always be supplied which either come with the supply from the wholesaler or can be produced in the pharmacy though I found many patients on long term medication did not require a pil every time. I find the advantage of blister packs is that you can check you have been dispensed the correct tablet/strength but the drawback is the difficulty popping the tiny tablets out.

The monthly supply is for our own protection as we require monthly blood tests and being supplied with more could lead some patients not bothering with the blood test.

I don't think you are mad but think you should talk to your pharmacist ( not pharmacy assistant) who can reassure you and dispense what you would prefer blister or loose with non childproof top though not the quantity as that is dictated by the GP.

Midwife1986 profile image
Midwife1986

Hi I get mine loose in bottles and was given info sheet by my consultant and with my first prescription by the pharmacist. I only get 4wks supply at a time which is annoying when I go on holiday and have to keep asking for more... which is a lot as I’m now retired and fortunate to go on lots of holidays .

Chance_chance profile image
Chance_chance

Yes mine are always like that loose in small brownish bottle/pot

Gardening1993 profile image
Gardening1993

Hi, my prescription was also in a bottle with no I formation sheet. Very strange.

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