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Worcestershire Treatment Pathways

Protocol for the Administration of Subcutaneous Methotrexate by Rheumatology Nurses, Patients and Carers

This protocol does not override the individual responsibility of health professionals to make appropriate decision according to the circumstances of the individual patient in consultation with the patient and /or carer.  Health care professionals must be prepared to justify any deviation from this guidance.

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Pathway Information

Methotrexate is an anti-metabolite cytotoxic agent.  It can be administered orally, and by subcutaneous and intramuscular injection. It has an immunosuppressive action and is used to treat rheumatic disease.  The rational for considering the administration of Methotrexate using the subcutaneous route has been driven by the need to increase the therapeutic dose, ensure the maximum bioavailability and reduce symptomatic side effects for some patients.  Methotrexate is now available in licensed manufactured pre-filled syringes.  The ability of a patient to inject in their own home can produce a significant degree of independence for the patient and is also a cost effective treatment pathway, avoiding unnecessary hospital attendances and for the need for direct healthcare practitioner support.  

Page last updated: 22 April 2016