We thank Gupta and colleagues for their comments on our article1. We read with interest the recommendations by the Australasian Psoriasis Collaboration of specified dosing with methotrexate Mondays and folate Fridays. This is an extension to the “name the day” recommendation set out by the Therapeutic Goods Administration in 1998.2 However, there are concerns with naming Mondays, as this has been mistaken for “mornings” and has been the cause of previous daily dosing errors.3 We welcome any efforts aimed at reducing inadvertent daily dosing; however, as outlined in our article, we believe that more needs to be done. Despite the fact that the recommendations of the Australasian Psoriasis Collaboration were released in 2014, we have seen an increase in dosing errors reported to the Australian Poisons Centres in 2014–2015.
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- 1 New South Wales Poisons Information Centre, Children's Hospital at Westmead, Sydney, NSW
- 2 University of Sydney, Sydney, NSW
- 3 NPS MedicineWise, Sydney, NSW
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- 2. Adverse Drug Reactions Advisory Committee. Methotrexate — name the day. Aust Adv Drug React Bull 1998; 17: 3.
- 3. Institute for Safe Medication Practices [website]. Beware of erroneous daily oral methotrexate dosing. Horsham: Acute Care ISMP Medication Safety Alert! 2002. https://www.ismp.org/newsletters/acutecare/articles/20020403.asp (accessed June 2016).
- 4. Ortiz Z, Shea B, Suarez Almazor M, et al. Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis. Cochrane Database Syst Rev 2000; (2): CD000951.
- 5. Hoekstra M, Haagsma C, Neef C, et al. Splitting high-dose oral methotrexate improves bioavailability: a pharmacokinetic study in patients with rheumatoid arthritis. J Rheumatol 2006; 33: 481-485.