The high doses of acetominophen required for pain relief over a long-term of months or years cannot be recommended because of the risk of liver and kidney toxicity. You would do better if you leave the acetominophen out and just take codeine. Step 2 Immune Suppressants Penicillamine, chloraquine, gold injections and methotrexate emerge as favored drug therapies, beyond prednisone. All are potent drugs with major side effects and moderate to high risk. There is a trend to recommend more aggressive drug treatments, using drugs that inhibit the immune response.
Gold can prevent disease progression by injection or orally.
C areful monitoring of gold therapy is important. Complete blood counts, platelet counts and urinalyses must be done at the time of each injection. Eye monitoring is necessary to check for visual loss at an early reversible stage. Patients should be seen by their eye doctors at least twice a year. Complete blood counts, platelet counts and urinalyses should be done monthly for the first six months of therapy and every other month thereafter.