Hello Everyone

Consultant last May prescribed me with MTX, I needed another DMARD added. I was given a 6 weeks prescription for MTX and folic acid at the hospital and then when I saw the specialist nurse to see how I'd be getting on with I was given another one for three months. She told me to get in contact with my doctors to see if they would continue with the meds. Being Mrs Organised I contacted the surgery about 6 weeks before I would run out and was told that they would be happy to issue them to me. About a week after that I picked up my other meds from the chemist and when I had to tick the drugs for my next prescription, I told them about the MTX and folic acid and they added it on to the list. Sure enough when I picked up the meds a month later the MTX and folic acid where there but it had not been printed on the repeat bit for me to tick. (I hope you understood all of that).

Everytime I have been since it's not on there and has to be written on by the girl at the chemist. I couldn't understand why, so I phoned my surgery up last Friday to ask why. The lady on the phone looked at my records and told me it was down as an 'acute' drug and I have to request it. This got me abit confused, my meaning of the word acute is something that goes away, with chronic being long term. RA is a chronic illness. She told me if I wanted it put on on a regular basis I should tell the chemist this and for them to write it down, then a GP will look at it and decided if I can have on repeat. 'Confusing or what?

As far as the folic acid goes........I take one once a week, so I should have 4 a month. When I picked up my monthly meds last month I had been given 28 tablets, my first thought was I had been given 6 months supply in one go. I have read somewhere that the chemist charges a fee for dispensing the drugs so it would make economic sense to give me alot in one go. But no, I read the instructions and it said take 1 a day.....hence me getting 28. Now I know what I'm doing with my drugs and how to take them, but when you consider that I take 5 different drugs, all different quantities, at different times of the day and two I only have to take weekly it is a bit alarming that they got it wrong. Someone elderly or who gets confused easily would look at whats printed on the box and take them accordingly. Even if there was some confusion when I told the girl at the chemist what I want and its not been put down right, the doctors should check my dosage and issue a prescription with the correct dose on it. If they had got the MTX wrong and I was told to take that daily and I did, heaven knows what the outcome would of been.

Do you think I should complain to someone?

Paula x

Hi Paula

My Methotrexate was always on repeat prescription throughout the ten years or so I was taking it, in fact I had to ask the doctor to remove it when I came off it! Our surgery add issue numbers so for example Methotrexate was on an automatic yearly review and I collect prescriptions two monthly Methotrexate would be issue 1 of 6, when it reaches the 7th prescription it flashes up for review. Some are shorter term depending on the drug involved.

Can you ask the doctor to add it to your prescription? This is how it is done at our surgery ... the pharmacy just send you back in to the doctor if it's not right.

You do have to watch what the pharmacists hand out ... it could be quite lethal concoctions!

Lyn x

The reason my mtx is not listed on my repeat list is because a few years ago a woman died in Huddersfield after taking mtx daily instead of weekly. Apparently it had been wrongly prescribed and the receptionist was just repeating it each time the woman requested them. Why the pharmacist didn't alert them to the mistake I don't know, but the consequences are that in this area it has to be prescribed each month by a doctor.
Perhaps something similar has occurred in your area Paula?
I don't have any problems getting them, I just ask for the repeats and then say I need mtx as well. The receptionist leaves a note for my GP and the tabs appear with the rest of my repeats.

Doreen xx

I thought they didn't prescribe 10mg tablets anymore because they were too similar to th 2.5 and so it was too easy to over-dose.
Sue

Thank you all for your replies.

Suzanne..I was thought that 10mg ones had stopped being given out too. Was told this was incase you had been use to having 2.5mg ones, then given 10mg ones you may take 4 times too much and well, end up with serious problems the worse case being dead!!!

Doreen....thinking about it, when I rung up to enquire about MTX was told that the doctor always asks about my blood test and to check that I have been having them done before he will authorise the prescription, so that probably why its not automatically on repeat. So I will give them 10/10 for that.

Now the folic acid...............I've thought about it alot since my post and after reading what Doreen said I decided to ring up the surgery. Before I asked to speak to the Practice Manager I enquired about the prescription in question. It may of been the pharmacy that made the mistake. No, I had been given a prescription for it to be taken daily. According to my records the dose was daily, but she found the letter from the consultant and that read weekly. So who had entered the data on my records at the surgery had made the mistake.

I was then transferred to the Practice Manager, I did keep emphasising that I didn't want to get anyone in trouble but I wanted to make them aware of what happened and they should try to put things in place so that this couldn't happen again. I did tell her what Doreen had said about someone dying from a result of taking MTX daily. I did point out to her that when first diagnosed with RA people are put on a variety of drugs, the DMARD's being quite toxic, some people are put on triple therapy along with pain killers, stomach protector and I myself was put on amitrp....???(spelling) at first to help me sleep. You have enough of a shock being given the diagnosis let alone taking on board quantities and when to take the drugs.........so people will rely on instructions. May of been a bit too dramatic I know.

She thanked me for making her aware of what had happened and said it will be treated as a 'Significant Event'. There will be a meeting about it with the doctors and staff and they will discuss ways of making sure that this never happens again. It won't be this week, but I will be written to and told of events. She also wants to use it as a training tool in future staff training. I will give you an update when they do get in touch with me again. So at least they are taking it seriously.

Paula x x

hi Paula,

i have just re-read your original post and just realised that the Folic Acid was prescribed daily so a definate mistake !! i firstly thought you just meant you had been prescribed 28 tablets but not one daily !!

and yes i would most definately have rang my Practice Manager so that they were filly aware and hopefully extra steps put into place so that it doesn't happen again.

as for the 10mg Methotrexate i have always had a 10mg one as that's the dose i was first started on ... and in my booklet about the drug it does explain that the 10mg and 2.5mg come in different shapes but are similiar in colour.

as i said i have no idea why i've been given the 10mg as i didn't know any different so will continue on it without querying it as i have never known any different and am fully aware of the difference.

but has been interesting learning about it all.

Suzanne x

Hello Caz

Interesting what you said about acute drugs and SLZ being classed as one at your surgery. I take SLZ as well and it always appears printed on my repeat list and I just tick it every month. It's only the MTX and folic acid that I have to request. I was told that my drugs are up for review in four months. I only take drugs because of RA and these are reviewed by the consultant. Once when I was having a painful time on advice from the specialist nurse I went to see my GP to see about getting my pain killers changed. Nurse said that changing them might of helped until I got to see the consultant. My GP refused to alter them, said it was up to the consultant to do that, so why waste a valuable GP's appointment when they won't get involved with prescribing drugs for RA?

This isn't the first time that meds have been wrong. Many years ago when my daughters were in their teens, (there over 30 now,) they both had acne very bad. At that time doctors would prescribed tablets to help (don't know if they still do). Both girls were prescribed different tablets. I went to get the repeat prescriptions once and was given the wrong one for Julie, I was given a long thin box at the chemist for Julie, it had the contraceptive coil in it. But what would of happened if I had just be given some pills with her name on? When I took the prescription back to the doctors surgery it turned out that there were two patient with the same name and unfortunately the other Julie had a prescription waiting to be picked up as well. They didn't in them days ask for your address like they do now.

Not long after that, I had two more prescriptions made up for their acne and I took one in for my husbands grandma at the same time. She had tablets for high blood pressure. They had three prescriptions with the same surname but different Christian names. They got Karen and Julies labels mixed up. We noticed it straight away but what would of happened if it had been grandmas blood pressure tablets in one of the girls bottles and we hadn't noticed it? I went back to the chemist, the pharmacist couldn't apologise enough.

So check, check and check again your medications.

Paula x

There was a thread about folic acid a few weeks ago. Lots of us take various amounts. From what I know the guidelines from NICE now is one a week, so thats probably why I was only told to take one. The nurse did say though that if I had any side effects that bothered me they will then look at increasing the dose.

Paula x x