Methotrexate and Otezla

Methotrexate is a relatively new medication which hasn’t been used for very long in dermatology.

A patient calls the office asking about a MTX refill.  She was seen 5 days ago and says she has “been taking it every day as directed” and was surprised that it ran out so quickly.  She’s upset because she believes you sent in the wrong quantity to the pharmacy.

What’s wrong here?

Liver damage is the only concerning potential side effect of Methotrexate.

A young female college student comes to the office today for evaluation of widespread Psoriasis.  She’s a new patient so she has a lot of questions.  You try to answer her questions and provide a brief overview of the different treatment options that your supervising physician may discuss with her.  Generally speaking, is MTX likely to be prescribed in this situation?

An elderly patient with widespread Psoriasis is prescribed MTX today.  She’s a little hard of hearing and seems a little confused about how to take it.  Your supervising physician has already explained the proper use and has now left the room and is seeing the next patient.  What would be the most appropriate action to take in this situation.

Patients on MTX should avoid overuse of _______.

Patients who are unable or unwilling to have lab tests regularly performed are _______________ for MTX therapy.

Use of Otezla requires routine laboratory monitoring.

Otezla dosing should be adjusted in patients with a history of _______.

Please match the medication to its pregnancy category.