DMARD Prescriptions

DMARDS and biologics are a group of very potent medications which are used to suppress the immune system and are used in the treatment of a number of conditions, including (but not limited to):

• Rheumatology
  • Rheumatoid Arthritis
  • Psoriatic Arthritis
  • Ankylosing Spondylitis
  • Systemic Lupus Erythematosus
• Gastroenterology
  • Inflammatory Bowel Disease
    • Crohn's Disease
    • Ulcerative Colitis
• Dermatology
  • Psoriasis

These medications typically need close monitoring to ensure that they are not causing unwanted side-effects, especially those which may not cause any symptoms until it is too late - this can include bone marrow suppression which may result in anaemia or a weakened immune system which can lead to severe infections or even death.

It is important to ensure that you are up to date with these blood tests before we can safely issue your medication.

All patients who are on DMARDs or Biologic therapies should be under a secondary care team (specialist), and we take joint responsibliity in ensuring that the appropriate monitoring takes place.

As part of a number of measures to improve patient safety, we have updated our prescribing policy to ensure that patients on these important but potientally dangerous medications are safe. As such, we will be insisting that your blood tests are up to date before we can issue these prescriptions. We have recently introduced an electronic system which replaces the old NPSA "Purple Book" although we would encourage you to keep this up to date.

The blood tests should be requested by the specialist team (Rheumatology/Dermatology/Gastroenterology) so that the results go to the specialists. As of April 2022, it is recommended that these are done at the hospital rather than at the surgery. However, if you are unable to attend the hosptital due to mobility reasons, you may book an appointment at the practice, with our in-house phlebotomist.

Most of these medications require 3-monthly blood tests (including methotrexate, leflunomide, azathioprine and mercaptopurine) although some other only require annual blood tests once you have been taking them for over a year (sulfasalazine, mesalazine, olsalazine). Please speak to your specialist team if you are unsure.

If you request your medication and your blood tests are out of date, our reception team will ask you to arrange a blood test and will not be able to issue the medication until we have the results. This is because it is almost always safer for you to pause the medication than to continue taking it without having had the appropriate monitoring done.

It is your responsibility to ensure that your blood tests are up to date.

We understand that this is slightly different to before, but have made this change to ensure that you are able to take your medicines safely.

Many thanks for your understanding.