Injection: Methotrexate Template

Injection: Methotrexate Template

💉 Injection: Methotrexate Template

❓ Why is this important?

Methotrexate is a high-risk medicine requiring careful monitoring. This template ensures:

  • Safe administration – with pre-dose checks, risks, consent, and safety steps documented

  • Monitoring compliance – including FBC, LFTs, U&Es, infection status, and pregnancy exclusion

  • Patient safety – through folic acid cover, counselling, and toxicity warnings

  • Accurate coding – for audit and reimbursement

📊 High-level overview of the template structure

The template follows the same workflow as the Generic Injection Template:

  1. Pre-procedure checks – risks, consent, safety checks

  2. Administration details – reason for methotrexate, site, route, needle size

  3. Post-procedure documentation – outcome, advice, sharps disposal, Yellow Card if required

It also includes methotrexate-specific sections:

  • Indication (RA, psoriasis, IBD, oncology, or other)

  • Pre-dose checks (bloods, infection, pregnancy, interactions)

  • Folic acid cover documented

  • Patient counselling and safety reminders (weekly dosing, toxicity, alcohol, vaccination, leaflet)

📌 What do you need to know?

🧾 Local Enhanced Service (LES) Section

  • Where a Local Enhanced Service exists, a dedicated section will appear automatically at the top of the template.

  • This ensures correct coding and claiming for methotrexate injections.

  • You do not need to use a separate LES template.

🛠️ Pre-procedure

  • Risks discussed (pain, bleeding, infection, allergic reaction, fainting)

  • Consent obtained and recorded

  • Injection under PGD or PSD

  • 6 safety checks completed

  • Vaccine cold chain confirmed (if relevant)

💉 Administration

  • Record indication for methotrexate (RA, psoriasis/psoriatic arthritis, IBD, oncology, or other)

  • Route/site: SC upper arm, thigh, abdomen, or other

  • Record needle size

  • Confirm injection given and tolerated

✅ Post-procedure

  • Outcome: no reaction, faintness, pain/swelling, allergic reaction

  • Sharps disposed of safely

  • Aftercare advice given

  • Yellow Card submitted if adverse reaction suspected

💡 Hints and Tips

  • Always check latest blood results before administration (FBC, LFTs, U&Es).

  • Confirm no intercurrent infection and exclude pregnancy before dosing.

  • Document folic acid cover at initiation and throughout therapy.

  • Provide clear counselling on weekly-only dosing and toxicity symptoms.

  • Use the LES section at the top of the template for coding and claiming (appears automatically).

  • For long-term treatment, use recall/future actions to support monitoring schedules.

👉 See also: