What monitoring is necessary for patients on methotrexate?

Monitoring liver function tests and complete blood counts is essential for patients on methotrexate due to the drug's potential toxic effects on the liver and bone marrow. Methotrexate is an antimetabolite that can suppress the immune system and lead to hepatotoxicity. Liver function tests, including measurements of liver enzymes, help assess the patient's liver health and detect any early signs of liver damage.

Complete blood counts are critical for monitoring hematological side effects, such as leukopenia, thrombocytopenia, and anemia, which can occur due to methotrexate's impact on the bone marrow. Regular monitoring allows for timely interventions if adverse effects are detected, helping to ensure the safe and effective use of methotrexate in managing conditions like rheumatoid arthritis and certain cancers.

The other monitoring options, such as blood glucose, electrolyte levels, and thyroid function tests, are not as directly related to the specific risks associated with methotrexate therapy. While these tests may be important in different clinical contexts, they do not provide the focused oversight needed for managing the known side effects of methotrexate.