Which monitoring is necessary for a patient taking methotrexate?

The correct approach to monitoring a patient taking methotrexate involves conducting full blood count (FBC), urea and electrolytes (UEs), and thyroid function tests (TFTs) every 2-3 months. Methotrexate is an established disease-modifying antirheumatic drug (DMARD) used for conditions such as rheumatoid arthritis and psoriasis. Due to its potential for causing hematological, renal, and hepatic toxicity, regular monitoring is essential to identify any adverse effects early.

FBC is crucial for detecting hematological abnormalities such as leukopenia or thrombocytopenia, which can occur due to the myelosuppressive effects of methotrexate. Urea and electrolytes help monitor renal function, as methotrexate can affect kidney health, particularly during initial dosing or in dehydrated patients. Although thyroid function isn't directly impacted by methotrexate, monitoring TFTs can help evaluate overall patient health, especially if there are underlying risk factors for thyroid disease or if the patient exhibits symptoms suggestive of thyroid dysfunction.

Regular monitoring every 2-3 months strikes a balance between sufficient oversight to catch any potential side effects early while not being overly frequent to burden the patient. Thus, routine testing is vigilant enough