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Leyla Hannbeck, head of pharmacy at the National Pharmacy Association, answers three of the 700 questions fielded every day by the NPA’s Pharmacy Services team

How long should a person wait after taking methotrexate before conception?

The Summaries of Product Characteristics (SPCs) for Maxtrex tablets 2.5mg and 10mg advise men and women to wait for three months after discontinuing methotrexate treatment before conception. This period can vary between different generic products. Furthermore, methotrexate is contraindicated in pregnancy and the licensed product information should always be followed. The UK Teratology Information Service states that there is limited published data on potential teratogenicity for low-dose exposure and paternal exposure to methotrexate. It is, therefore, suggested to wait six months, which is equivalent to two sperm cycles, after methotrexate exposure before conception. NPA members can download an SOP for ‘Supplying oral methotrexate’ from the NPA website.

Can a person donate blood on the same day they have received a hepatitis A vaccination?

 depends on whether the person was given a hepatitis A vaccination for travel purposes or for post-exposure to hepatitis A. Blood donation is suitable on the same day as receiving a hepatitis A vaccination if the vaccine was given for travel purposes. However, a person would have to wait six weeks from receiving a hepatitis A vaccination to donate blood if they have been given the vaccine for post-exposure to hepatitis A.

What is the difference between Fortini 1.0 Multi Fibre and Fortini Multi Fibre liquid?

The differences between the two are the calorie content and uses: • Fortini 1.0 Multi Fibre is a 1kcal/ml sip feed and is indicated for malnutrition or undernutrition • Fortini Multi Fibre is a 1.5kcal/ml sip feed that can be used for malnutrition or undernutrition, as well as critical care, cystic fibrosis, diabetes, failure to grow or thrive, and gastrointestinal problems. Both enteral sip feeds are nutritionally complete, ready to drink and come in a 200ml bottle in banana, chocolate, strawberry and vanilla flavours. The composition of fibre is 60 per cent soluble and 40 per cent insoluble; they are also both gluten- and lactose-free. They can be used as a sole nutrition in children aged one to six years or who weigh 8 to 20kg.