Methotrexate: beware of overdose!

Methotrexate is a molecule prescribed to patients suffering from psoriasis, rheumatoid arthritis or even acute lymphoblastic leukemia. The National Agency for the Safety of Medicines and Health Products (ANSM) invites patients who take it to be cautious.

Beware of the risk of overdose or drug interaction

Methothrexate should be taken only once a week and vigilance is required when taken with other medications. To avoid an overdose, it is requested by the ANSM:

• To take these drugs once a week only;
• Not taking other prescription or over-the-counter treatments (including nonsteroidal anti-inflammatory drugs [ibuprofène, kétoprofène, aspirine, etc.]proton pump inhibitors [oméprazole, pantoprazole, etc]) without the advice of a doctor or pharmacist.

For Dr. Yves Dour, pharmacist and member of the Doctissimo expert committee, “this information has been passed on to us for more than ten years, but it is important to regularly remind professionals and patients, especially those who have been taking the molecule for a long time and for whom we do not always think of remember the basic rules.

In case of methotrexate overdose

Indeed, when taking too much methotrexate, the following symptoms may appear: “fever, sore throat, mouth ulcers, diarrhea, vomiting, rash, bleeding or unusual weakness” reminds the health authority. In the event that you present this type of symptom, it is important to consult a doctor quickly, specifying that you are taking this molecule.

To help you, an information card is provided in the boxes, to remind you of the dose of methotrexate to take and the symptoms of overdose. It should be kept and presented to the healthcare professionals you consult, but also to the caregiver to keep them informed of the use of this treatment.

“To avoid any risk, I advise the patients concerned to avoid medical nomadism: they must try to consult the same doctor, to go to the same pharmacy… This allows us to get to know our patients better and to avoid risky drugs for them. interactions or side effects” recommends the pharmacist.

Advice for healthcare professionals

Health professionals also have certain recommendations to follow, to limit the risks of overdose and interactions. The ANSM asks them, each “prescription, renewal or dispensation” of :

• “Make sure patients understand that the medicine should be taken only once a week;
• Inform them of the risks of overdose in the event of taking other medications at the same time (in particular nonsteroidal anti-inflammatory drugs and proton pump inhibitors);
• Inform them of the signs of overdose and to contact a doctor quickly in case of suspected overdose;
• Decide in consultation with the patients, during dispensing, the day of the week when the medicine should be taken and ask them to write it on their patient card present in the box;
• Pay particular attention to elderly patients and/or patients with cognitive disorders because of the greater risk of confusion and also inform caregivers“.