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Canadian Pharmacist Qualifying Exam Practice · Question

A 45-year-old female with Crohn's disease is prescribed methotrexate 20 mg weekly. She has no other comorbidities. What common drug-induced adverse effect should the pharmacist counsel her on, and how can it be mitigated?

Methotrexate commonly causes mucositis, including oral ulcers, due to its antifolate effects. Folic acid supplementation is routinely prescribed to mitigate the

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Question: A 45-year-old female with Crohn's disease is prescribed methotrexate 20 mg weekly. She has no other comorbidities. What common drug-induced adverse effect should the pharmacist counsel her on, and how can it be mitigated?

Answer options:

  • Hepatotoxicity; monitor liver enzymes regularly.
  • Nephrotoxicity; ensure adequate hydration.
  • Myelosuppression; advise infection precautions. ✅ Oral ulcers; recommend folic acid supplementation.

Correct answer: Oral ulcers; recommend folic acid supplementation.

Explanation: Methotrexate commonly causes mucositis, including oral ulcers, due to its antifolate effects. Folic acid supplementation is routinely prescribed to mitigate these side effects without compromising the efficacy of methotrexate for Crohn's disease.

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