Alan Crabtree

“The dose regime referred to in the "Shared Care Guideline for Oral Methotrexate in Rheumatological Conditions in Adults" does not reflect current practice and the initial dose recommended is a sub-therapeutic dose.”

“The "Shared Care Guideline for Oral Methotrexate in Rheumatological Conditions in Adults" was produced in September 2017. Since then, the "Pharmacy First" scheme has come into effect. The guidance therefore does not reflect the changes in the relevant responsibilities between secondary care, GPs and community pharmacists leading to ambiguity as to what type of healthcare professional a patient should consult and potentially fatal delay in ceasing methotrexate or commencing treatment for toxicity for the same.”