Methotrexate : Hello lovely people. I have discovered... - NRAS

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Methotrexate

Slife profile image

Hello lovely people. I have discovered that my request for repeat prescription of methotrexate has been rejected by my GP. Wondering if this has happened to others? I was not given an online reason. Trying to get hold of surgery is a marathon task…

Thank you

67 Replies

Are you up to date with your blood monitoring? This can stop a prescription of mtx being issued.

I've had the same problem many times. Usually it is because I have requested it online a day or so before the approved renewal date. This is a particular problem as they give me a prescription for a 28 day supply regardless of the days in the month. Apparently all months have 28 days! I end up ringing the surgery, explain that it is prescribed by the consultant and is non negotiable and will they have to get the doctor to approve it. It then goes through, but it is exceptionally annoyed have to do it on a regular basis. The only other times are if my bloods are not up to date, and that is usually because I cant get a blood appointment even though I have tried to arrange one.

Slife profile image
Slife in reply to Potatos

It’s all so needlessly complicated!!

AgedCrone profile image
AgedCrone in reply to Slife

No…it is for our safety……Mtx is not a drug to be messed with.

Chris_O profile image
Chris_O in reply to AgedCrone

Hi

Unfortunately all safety procedures are not foolproof. Yes you could have say, one months plus one weeks supply of methotrexate, but I’m sure most of us keep a strict record of how often we take it. To play devils advocate with safety procedures, what’s to stop you taking all of your months supply of methotrexate in one go? Not that I’m recommending that. There comes a time when you have to trust patients with some risk.

Chris_0

AgedCrone profile image
AgedCrone in reply to Chris_O

If you had ever been a nurse you would know how confused some patients can get about taking their meds.I agree sometimes it seems like overkill…but I guess better safe than sorry.

10pinbowling profile image
10pinbowling in reply to Chris_O

Hi. I'm on methotrexate and luckily for me I have no trouble with prescriptions from my surgery which always has 24 tablets each time. Perhaps it's the joy of living within a small surgery.

Shamrockgirl profile image
Shamrockgirl in reply to Slife

I’ve had it happen occasionally, usually due to it being requested a few days too early, then when electronic prescriptions came in, but Methojet was still on the green paper ones.

Appreciate what AgedCrone says, but many of our lives are complicated, with various conditions, fatigue, rest of our life & much else is complicated. So it seems yet another added hassle you don’t need. I think we all know Methotrexate is not like other meds.

dawkin_S profile image
dawkin_S in reply to Potatos

Oh gawd, Potatos - I go through this same rigmarole virtually every month! I even had one receptionist arguing that I didn’t need my prescription yet and it wasn’t until I literally counted out the days of the month to her that she conceded that yes, I did need the next month’s methotrexate by tomorrow. Luckily my pharmacy are great and often chase it, but it is so frustrating.

dawkin_S profile image
dawkin_S in reply to dawkin_S

You couldn’t make it up - other half went to pick up prescriptions the very next day afterI wrote this, only to find - yep you guessed it - no methotrexate!

I have to be up to date with blood tests or they won’t prescribe it. Have you had yours recently?

Slife profile image
Slife in reply to KittyJ

Yes In December,although the results haven’t been shared with me. Thank you for replying

HI Slife. I had exactly the same problem last week. When I checked on the Practice site a couple of days after requesting it, it said Rejected by GP. I went onto another page and found that it actually had been accepted. I think Potatos is right and if you request it a day or two early, it is rejected until the actual renewal date. Just to check, I rang the pharmacy to be told that they had received it and it was ready for me to collect it.

Slife profile image
Slife in reply to springcross

Thank you. So, if you are going away you are a bit stuffed??? It definitely wasn’t approved as I have collected my ‘trolley load’ of other meds. They seem to be ok on any date!

springcross profile image
springcross in reply to Slife

Yes mine are usually OK if I request early and this is the first time it's ever happened to me, but on saying that, I don't usually bother to check their page online - I just wait for the text to come through from the pharmacy to say it's ready, but I'd read somewhere that there may be a shortage of MTX and that's what caused me to look. I hope you get yours soon.

ABwn profile image
ABwn in reply to Slife

If I'm going away I let my doctor know why I need the script early.

CripLady profile image
CripLady in reply to ABwn

Same; never had any problems.

I have had the same thing with asthma inhalers, though not with methotrexate because my hospital still prescribes that.

That's really annoying for you. I hope it doesn't become a habit with them.

That really isn’t helpful for you! I have them too- breathing is quite important 🙃

I can’t get mine through my gp I have to get it through the hospital pharmacy were my consultant is my own gp won’t prescribe it costs or something???!!!

Same for me for Methotrexate injections - apparently my health authority doesn't allow shared care with the GPs for those.

It’s a restricted med. Injections you usually have to get from the hospital pharmacy. Tablets your GP can do.

Mall profile image
Mall in reply to CripLady

My GP prescribes injections. They are strict on monitoring though.

I didn’t realise how much it all differs! On the face of it it would appear quite straightforward?? Anyone would think we actually like it..

Zara0123 profile image
Zara0123 in reply to Slife

Lol. Maybe they should have a trial test for taking Mtx and they can share some of the side affects that we have to live with. Then they will realise no one would take more then needed to have an easier life living with RA.

Mine is usually if my bloods aren't up to date. The ridiculous thing is, the GP practice insist on doing some of the same bloods as the ones my consultant requests. They always get a copy of them ,so I asked if duplicating them was necessary as it's a waste of resources. The answer was they needed them to continue issuing the mtx 🙄

Frances_UK profile image
Frances_UK in reply to MadBunny

Madness.

MadBunny profile image
MadBunny in reply to Frances_UK

Yep. The lady who does my bloods said it often happens 🙄

Frances_UK profile image
Frances_UK in reply to MadBunny

You shouldn't have to have any unnecessary tests. If it were me I'd do the GP ones because they can be accessed online and the consultant can look them up, and not the consultant ones. But that depends on your situation.

MadBunny profile image
MadBunny in reply to Frances_UK

I would but there are some which aren't duplicated and requested by the consultant only.

do not take it...U

I order my mtx a week before the last date on my box's I have received. The GP sends them to my chemist who deliver them to me. BRI have told me to order when you have two left so a not to run out.

Many years ago my gp would not give me a prescription so had to get a hospital prescription just because he did not agree with the drug. No problems with a different surgery when i moved cointy.

No, not yet. Good luck.

I hope you won't mind me asking, is this Methotrexate tablets? As I won't be able to collect my injectable ones from the chemist, this is dealt by a private company on behalf of the national service and it's directly delivered to my door

Slife profile image
Slife in reply to Curcubeu

Yes tablets

Mall profile image
Mall in reply to Curcubeu

I collect methotrexate injections from my local chemist; I also take Benepali which is delivered by NHS.

Popinjay profile image
Popinjay in reply to Curcubeu

I get my injections from my GP 4 weekly have done for the past 7 years

Have you missed a blood test?

Slife profile image
Slife in reply to AgedCrone

No I haven’t

Yes all the time. As if life with a chronic illness isn’t bad enough , my GP would not issue an automatic repeat prescription and I had to contact them every time … even though my bloods were up to date … by the way, I also had to contact them for individual blood slips every time 🤬😡Apparently they’re too busy to see patients … probably because of things like this!

madme1 profile image
madme1 in reply to LinaM

I get that with blood forms regularly LinaM, and spent years getting stuck between my gp and the hospital as they argued who should do the forms. Now I wait until I've got one or two forms left and when I next speak to the consultant/nurse I ask for one.

Hi

I had a similar thing happened to me on my GPs NHS online drug reordering program. The problem was, after much hassle, that the NHS online drug reordering program had a 30 day limit on repeat prescriptions. So for drugs like methotrexate, if you ordered it at say 29 days after the first request, the program automatically rejected your request!

I know it’s a safeguard, but to be so rigid was just daft. Anyways, after much hassle, letter writing etc, it’s been changed to sensible limits. Now the request program seems to have gone to the complete opposite - I recently had sciatica and the GP who actually saw me, prescribed co-codamol, and now this is on the repeat prescription!

Oh, I just remembered that last week I had to miss a methotrexate injection because even though my repeat prescription went in at the correct time. It was on a Friday, so probably a delay in getting it authorised by a GP and then a delay by the chemist in ordering from their central supplier, but what can you do?

Chris_0

Potatos profile image
Potatos in reply to Chris_O

I have had the same issue and have had to miss doses whilst I wait for a prescription to be renewed. Most months have 30 or 31 days but I am only ever given a 28 day supply. The computer then resets the date for reorder for for a calendar month ahead. This means I am regularly short of a dose. Years ago I was able to get a three month supply and order early, that also made it much cheaper as now it is 12 rather than four prescriptions annually.

Chris_O profile image
Chris_O in reply to Potatos

Hi Thanks for the reply. When I started having problems with prescription requests being rejected, I decided to make life as difficult as possible for my GP. Lots of written letters outlining the problems and telephone calls. I guess she eventually got fed up with it and lo and behold, it changed!

Persistence pays off. I sometimes think that if the NHS was a private company run for profit, it would have ceased to exist long ago. LOL

Chris_0

Might b blood test needed first

If I dont get my bloods checked every 3 months my GP will not issue me my prescription. They r being cautious which I get when they do that. Could that be the possible reason?

LinaM profile image
LinaM in reply to HamHammy

Yes they told me that at one time , but suddenly during the pandemic it was ok to leave me on mtx without a blood test for 6 months ! I’m sick of GPs altogether tbh

Yes I get it happening occasionally. It’s usually that although my bloods are done, it’s the consultant that requests the bloods and gp do blood test. However they don’t flag up the results to gps. The results are on the national database, however my gp is forever saying she can’t see results. She’s not very good with computers. I usually then gave to phone rheumy nurse who confirms bloods are fine, and insists they can see each other’s tests, and she was able to read off tests the gp had ordered. My latest one was rejected and when I challenged gp she denied rejecting it 😂. My rheumatologist has just changed their shared care agreement, passing the ordering of bloods to the gp, so will see if things get better or worse. I do get 2 months supply each time though.

I had mine refused once and I was told it was because I requested them the week before my bloods were due testing. GP wanted the results before prescribing. M x

They won’t repeat ‘early’ as it is a restricted med. Also, you may need a medication review, or your bloods done.

My GP messed up my mtx so often I now get mine prescribed by the hospital. They really didn't want to prescribe it.

I had this once_ the prescription had not been financed by the hospital. Not sure why they were paying for it! Had to contact rheummy and it got sorted out. Best of luck. 😉

This has happened to me and it was because I couldn't get my blood tests on time. I understand the need to make sure that we are well enough to take such a dangerous drug and I am grateful for that but I also didn't want to miss a couple of doses. This also would have meant being in the same position every 3 months. I rang rheumatology and explained and they very kindly said they would give me a prescription as a one off to get me on the right track for further prescriptions.

I would suggest an email to the surgery empathising it is a drug prescribed initially by thespian and should not be stopped , it maybe your prescriptions need approval as they should be checked regularly to see if they can continue need to be approved by a pharmacist or Dr. Another way is to contact the Rhematology dept and let them know what has happened .Good luck.

My GP does the same if my blood monitoring is overdue. The routine 3 mthly blood tests don't always fit around the 2 monthly prescription requests. Easily put right, I keep a few extra methotrexate injections to cover this.

I've had this problem in the past Slife as Methotrexate is what they term as a controlled drug. I had kept up with blood monitoring and I remember that rather than going back to my gp, I went back to my rhuemy team. They in turn contacted my gp who then contacted the pharmacy, and whilst it took sometime it was eventually sorted.

I have this problem constantly. I don’t have MTX but used to get fentanyl patches and although I made them last six weeks instead of four I had to see my GP every month before I would get another prescription so eventually I got so sick of it GP and I came to an agreement as I had never shown any signs of addiction. Same thing with stoma supplies which I cannot do without 🙄 they decided I needed an annual review ???? what the hell for am I about to grow another colon lol. Makes my blood boil that although we absolutely have to be monitored and safe guarded common sense should also be used most of us are not stupid and wouldn’t mess with things like MTX.

This happened to me during the first locking when you blood tests had been missed my GP said he wasn't happy to prescribe until my bloods were done which he went on to carry out as I pointed out that the surgery was the obstacle in getting one because they had stoppedI did however as the RA help desk to email the gp to tell them that as I had, had no problems with my liver for 20 years of thing the MTX then I could be checked 3 monthly during the covid restrictions and it was left to me to take action if I felt my health changing or I thought I was having any symptoms of a problem wit my Liver

Appears I may be in the minority: on Methotrexate tablets and receive 100 in a plastic pot on repeat prescription via GP. The adhesive label on the box clearly states (inter alia) 15mg (Six Tablets) To Be Taken Weekly as per Rheumatology. To be administered ONCE A WEEK on the same day each week.

I have bi-monthly blood tests and I negotiated gradual reduction in the tablets in stages via Rheumy with Consultant consent. I’m in clinical remission and still have all my ‘marbles’, so far as I’m aware! 👍

might be a bit late with this reply, but your consultant sends a letter to your GP then you should be able to get it on repeat. Good luck.

My GP doesn't support me for my Methotrexate, I have to get my script from my consultant over 100 miles away. I don't have any problems and she gives me 3 months at a time x

I can’t get mine from my GP at all. Have to get them from the hospital something to do with the cost of them being too high.

Hi. Its interesting you posted this now as I have just been to get my first Methotrexate from my GP practice since they have now agreed shared care with the hospital. I usually got three months from hospital dispensing service but today have collected from my GP a small bottle with 8 loose tablets which is my weekly dose?! I also asked for Folic acid which they said hadn't been authorised from the hospital but conceded and gave me a packet. More phone calls I guess!

Methotrexate gave me lung fibrosis. If I were you I would look into this is you are taking it. A very dangerous drug.😂

Definitely has been a smooth transition so far with shared care services between my hospital and GP. Had a few teething issues requesting it on repeat at first but after a 'nice but firmly' worded email, it was sorted out pretty quickly. Hope that its a one-off issue for you.

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