However they have a high incidence of toxicity and may not change the course of rheumatoid arthritis. They should only be used in patients with activie synovitis in many joints. P rednisone is the preferred agent because of its cost and low potential for fluid retention. Tablets are available in 1 mg and 5 mg dosages. All patients should be educated about the side effects of corticosteroids.
Informed consent is most inportant in their use.
M ethotrexate is a new usage of a very old medication. Methotrexate should only be given by those physicians who are knowledgeable and experienced in its usage. The use of Methotrexate involves periodic monitoring for toxicity. Monitoring should include complete blood counts with differential and platelet counts. It should also involve liver and renal function tests.