The registered nurses at the health service here have asked me about a problem they have. A patient with rheumatoid arthritis has come in with methotrexate ampoules -50 milligram size.  The patient is being treated by an external consultant.  The dose is  25 milligrams, once per week.  It would be nice if it came drawn up in a syringe as the correct dose.

 

 I have been looking at the local information on cytotoxics and it does seem an extraordinary amount of equipment is needed for this one small dose.  I  wonder if there is anyone out there who has a procedure for working with small doses of cytotoxics because the potential cost of getting all the equipment and having it sit around and being only used once per week does seem extreme.  I understand the risks of cytotoxics but does the size of the dose matter? The Registered nurses are concerned about the patient because she apparently has multiple problems as well as the rheumatoid arthritis and they do not want to send her elsewhere.  I would appreciate advice on this matter.