TAM (Treatments and Medicines) NHS Highland
Important: Therapy notes
- Regular monitoring is required for all drugs listed, refer to DMARD monitoring.
- For NHS Highland Rheumatology Department GP and Patient information click here (NHSH intranet access required)
Drugs affecting the immune response (Formulary: Rheumatology)
What's new / Latest updates
24/07/26 (v1.1):
- Methotrexate tablets 2.5mg: amended '(s) to '(Restricted: Specialist recommendation only)'.
- Methotrexate injection pre-filled pen 7·5mg/0·15mL, 10mg/0·2mL, 12·5mg/0·25mL, 15mg/0·3mL, 17·5mg/0·35mL, 20mg/0·4mL, 22·5mg/0·45mL, 25mg/0·5mL, 27·5mg/0·55mL, 30mg/0·6mL: amended '(s)' to '(Restricted: Specialist initiation only)' and added 'To be administered via subcutaneous injection'.
Immunisation is actively promoted in patients with immune disorders, particularly if treated with immune-modulators; refer to Department of Rheumatology guidance ‘Vaccinations in the immunocompromised person’. Regular monitoring is required for all drugs listed, refer to DMARD monitoring.
Important: Therapy notes
- Due to differences in bioavailability, specify the brand of oral ciclosporin to be dispensed.
- For NHS Highland Rheumatology Department GP and Patient information click here (NHSH intranet access required)
- Regular monitoring is required for all drugs listed, refer to DMARD monitoring.
Important: Therapy notes
- For NHS Highland Rheumatology Department GP and Patient information click here (NHSH intranet access required)
- Note the requirement for antibiotic prophylaxis for some patients.
Important: Therapy notes
- For NHS Highland Rheumatology Department GP and Patient information click here (NHSH intranet access required)
- Regular monitoring is required for all drugs listed, refer to DMARD monitoring.
Important: Therapy notes
MHRA alert: Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing (September 2020) (www.gov.uk).
Oral methotrexate
- Pay attention to the strength of methotrexate tablets prescribed and the frequency of dosing; methotrexate is always given weekly. Prescribing and dispensing errors have caused fatalities.
- Folic acid (Anaemias and some other blood disorders) may lessen some toxic side-effects of methotrexate, eg nausea and mucositis (see dose advice in GP leaflet) but continued monitoring of the full blood count, liver and renal function tests and a close watch for other untoward symptoms are required.
For NHS Highland Rheumatology Department GP and Patient information click here (NHSH intranet access required)
Regular monitoring is required for all drugs listed, refer to DMARD monitoring.
Important: Formulation and dosage details
Formulation:
Tablets 2·5mg (Restricted: Specialist recommendation only)
Important: Formulation and dosage details
Formulation:
Injection pre-filled pen (Metoject®) 7·5mg/0·15mL, 10mg/0·2mL, 12·5mg/0·25mL, 15mg/0·3mL, 17·5mg/0·35mL, 20mg/0·4mL, 22·5mg/0·45mL, 25mg/0·5mL, 27·5mg/0·55mL, 30mg/0·6mL (Restricted: Specialist initiation only)
Dosage:
To be administered via subcutaneous injection.
Patient information: Button-free autoinjector PEN - Metoject® PEN (methotrexate)
Important: Formulation and dosage details
Formulation:
Solution for injection pre-filled syringe (Methofill®) 7·5mg/0·15mL, 10mg/0·2mL, 12·5mg/0·25mL, 15mg/0·3mL, 17·5mg/0·35mL, 20mg/0·4mL, 22·5mg/0·45mL, 25mg/0·5mL, 27·5mg/0·55mL,30mg/0·6mL (Restricted: Specialist initiation only)
Dosage:
To be administered via subcutaneous injection.
Important: Formulation and dosage details
Formulation:
Solution for injection pre-filled injector (Methofill®) 7·5mg/0·15mL, 10mg/0·2mL, 12·5mg/0·25mL, 15mg/0·3mL, 17·5mg/0·35mL, 20mg/0·4mL, 22·5mg/0·45mL, 25mg/0·5mL, 27·5mg/0·55mL, 30mg/0·6mL (Restricted: Specialist initiation only)
Dosage:
To be administered via subcutaneous injection.
Important: Therapy notes
- For NHS Highland Rheumatology Department GP and Patient information click here (NHSH intranet access required)
- Regular monitoring is required for all drugs listed, refer to DMARD monitoring.
Important: Formulation and dosage details
Formulation:
Important: Formulation and dosage details
Formulation:
Tablets 500mg (specialist initiation/recommendation only)
Important: Formulation and dosage details
Formulation:
Oral suspension 1 gram/5mL (specialist initiation/recommendation only)
Important: Therapy notes
- Regular monitoring is required for all drugs listed, refer to DMARD monitoring.
Important: Formulation and dosage details
Formulation:
Enteric coated tablets (as mycophenolate sodium) (Myfortic®) 180mg, 360mg (specialist initiation/recommendation only)