Catastrophic adverse events associated with methotrexate toxicity can occur following daily administration of oral methotrexate when weekly administration was indicated or intended.
The Methotrexate (Oral) Standard of the NSW Health High-Risk Medicines Management Policy (PD2020_045) outlines the minimum actions required to reduce risks associated with oral methotrexate. The Methotrexate Standard includes a risk mitigation strategy, and also addresses oral methotrexate prescribing, storage, supply, administration, patient monitoring, pharmaceutical review and patient information and education.
The tool below can also be used to assist hospitals in monitoring risks associated with oral methotrexate. It can also be used to monitor local implementation and compliance with the Methotrexate (Oral) Standard of the High-Risk Medicines Management Policy.