What blood monitoring do I need with methotrexate?

[Lupymo]

Hi I’m in hospital with multiple leg fractures (open tib fib) since a week ago . My methotrexate bloods were last done at GP in January and delayed Feb/March as I was overseas re turned a few days before lockdown and all routine bloods were cancelled in my case till July as per Scottish nhs pandemic protocol. Intended to get them done at GP this week.

Fast forward to hospital stay, I’m getting the run around asking for routine methotrexate monitoring. My dose last Friday was missed due to infection risk which is fine. I would like reassured but can’t remember the list of blood tests to request. I am beyond fed up being humoured and told the tests I’ve had in hospital are just routine. When I got transfused the other day I said so I guess I’m anaemic then as shown by FBC test! Also fed up being gaslighted

[Hidden]

Hi lupyno

So sorry to hear about your fractures. With an open wound rheumatology may advise you to hold off on the mtx best ask them.

The blood tests for mtx monitoring are routine. Nothing special about them at all.

They are full blood count

Urea and Electrolytes and

Liver function tests.

Fbc, u's & e's and lft's.

I'm sure the hospital have already checked them especially if you've had surgery.

Wishing you a speedy recovery

Best wishes

Kiki

[allanah in reply to Hidden]

I agree with kiki, normally you stop mtx if you have wound or operation or infection.

[Lupymo in reply to allanah]

Thanks for replying. This morning I know I’ve had fbc and kidney ? Function checked out and infection markers which when I pressed the phlebotomist, agreed it was CRP. They were due yesterday but it didn’t happen.

I dont have 100 per cent confidence That routine stuff is taken care of based on my experiences to date but the emergency blue light stuff, thank God for our NHS.

[Tamtan2 in reply to Lupymo]

I have pmr and Gca. I was on mtx then came off it myself as I was so ill after 8 weeks on 10/20 I have had no life aching unable to walk this has gone on for months just on prednisone 25 mg Think I’m recovering slowly from side effects of mtx and AA breathlessness endoscopy showing right lung nodule and hernia I haven’t seen anyone for months due to the crisis we are in at present 😷which I totally u derstand. Second ct scan august dexa scan august bloods on Friday every month not 2 weekly. Take care and read about your meds Rhuemy nurse looking into tapering after asking a million times And requesting dexa scan all be it a bit late fingers crossed for next month.🙏🏽

[BoneyC]

... ditto FBC's, LFT's, U&E's, but add on ESR & CRP (both inflammatory markers).

[Cactiman]

It’s usually every 2 weeks for a few months then once a month.

[NN55]

Hi Lupymo as long as you have had full blood count, urea , electrolyte screen, liver function tests and Erythrocyte sedimentation rate or C Reactive Protein this should be sufficient and all of these tests should have been done routinely during your admission at some point. If you have. An open fracture you are more. At risk of infection so they will probably advise to skipthe Methotrexate . Get well soon

Nicola x

[Lupymo]

Thanks to all who replied. I don’t believe I’ve had liver function tests or ESR but can ask again...