New research published in the BJGP from Dr Ben Goldacre’s team in Oxford found that 23% of GPs still prescribed different strength methotrexate tablets (10mg and 2.5mg) to the same person in the past year — against the safety advice.

Overall though, it is improving and in the past 10 years, prescriptions of 10mg tablets have dropped from 9% to 3%. Brian MacKenna, Pharmacist Researcher, recommends every GP should visit and review their own prescribing — the clear message for practice from the research is that GPs should check their prescribing and start processes to switch people from 10mg methotrexate tablets.

Watch the short videos below and read the paper:


Deaths from methotrexate poisoning in England and Wales (1993-2017)

Number of practices who prescribed 10mg methotrexate in England in 2017 (Total number of practices = 7349)

The research found that prescribing of 10mg methotrexate tablets has fallen, as a proportion of methotrexate prescribing, from 9.1% in 2010 to 3.4% in 2018.

Safe methotrexate prescribing is a priority NHS concern and is listed as a Never Event.

The Research

Brian MacKenna, Pharmacist Researcher at University of Oxford, talks about their new research into methotrexate prescribing. Read the paper:

In Practice

Dr Kevin Barrett, a GP, tells us about how his practice, many years ago, had a significant event involving a patient who had 10mg methotrexate tablets. Despite thinking they had banned 10mg tablets the highlighted a new patient who had slipped through the net.


Ben Goldacre gives a short walk-through on how works and how everyone, and every practice, can access prescribing data.

Article: Trends and variation in unsafe prescribing of methotrexate

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