Methotrexate remains an important therapeutic agent in Rheumatology, for Rheumatoid arthritis and other systemic and auto-immune diseases. Its prescription and subsequent use is often challenged by mis-information at the dispensing levels, often finding the origin of the mis-information in various therapeutic data-bases and drug-interaction programs. This constant and recurring challenge and inconsistency is not only frustrating our ability to deliver ‘standard of care’, but potentially subverts the therapeutic relationship with our patients. We have found it useful to add the following phrase (reviewed and endorsed by the Ontario Pharmacists Association) to our MTX ‘favourite’ in our EMR: “May be dispensed with NSAIDs and PPIs; not to be co-administered with Septra or Bactrim”. As well, we have developed the following ‘fax-back’ which can be used to facilitate education of our Pharmacist colleagues.
