Drug Information

This page contains patient information on the medications commonly used to treat rheumatological conditions

Methotrexate

This is the most commonly used drug for the treatment of Rheumatoid arthritis worldwide. It is also used to treat other inflammatory arthritis and for patients with resistant polymalgia or temporal arteritis. Although the side effects seem daunting, it is usually very well tolerated. Your rheumatologist will explain the side effects of this drug and send you a patient information leaflet. This medication can lower the white cell count, cause a rash, anaemia, abnormal liver tests, and in a small proportion of patients scarring of the lung tissue or an acute allergic reaction, recognised by the development of a dry cough and breathlessness. Please see the link to Arthritis UK for further information on this drug, including side effects. A baseline chest X ray will be organised to ensure that this is normal before commencing the drug, in the event of the rare side effects of lung complications on taking the medication.

Methotrexate is usually prescribed as 2.5mg tablets, with the dose ranging from 7.5mg to 25mg weekly. These will be taken at once, one day per week. One folic acid tablet is taken once a week, the day after methotrexate. This helps to protect against anaemia and the development of nausea. The folic acid tablets may be increased by your rheumatologist if you experience nausea.

Safety blood tests are performed fortnightly after commencing the drug, for 2 months. Once on a stable dose, this will become monthly. If your dose is increased, the blood tests will once more be done every 2 weeks.
If you develop a persistent dry cough or breathlessness, please contact your GP and rheumatologist. NB. Methotrexate must be stopped if you develop a severe infection or any infection requiring antibiotics.
You are advised to have a yearly flu vaccine. If you have flu, methotrexate must be stopped and you must tell your GP and rheumatologist.

Sulphasalazine

Sulphasalazine is used in the treatment of Rheumatoid arthritis and other inflammatory arthritides. Your rheumatologist will explain the side effects of this drug and send you a patient information leaflet. This medication can lower the white cell count, cause a rash, anaemia and abnormal liver tests. Please see the link to Arthritis UK for further information. Safety blood tests are performed fortnightly after commencing the drug, for 2 months. Once on a stable dose, this will become 3 monthly for the first year and then 6 monthly.

NB. Sulphasalazine must be stopped if you develop a severe infection or any infection requiring antibiotics.

You are advised to have a yearly flu vaccine. If you have flu, sulphasalazine must be stopped and you must inform your GP and rheumatologist.