Methotrexate is considered the "gold standard" in the treatment of RA. I have taken it for 35 years. Doctors now feel that aggressive treatment early is a good idea- prevents damage to joints. My mantra: TRUST YOUR DOC, TRY THE MEDS. Good luck Pamela.

Most people go on methotrexate first before anything else. The doctor does have to make sure your liver can handle it, but the amount can be tweaked for you. I started on 20mg methotrexate first (8 tablets) and my liver function got a little worse. My doctor told me to adjust my diet (cut out red meat) and she had me start drinking a small amount of lime juice and warm water each morning to help with digestion. Within 6 weeks of doing this my numbers improved greatly. She increased my methotrexate to 25mg per week and my folic acid to one tablet each day. By itself that was not working so she then added Plaquenil. A while later she added Sulfasalazine. She said normally that I would go on Enbrel after not having success with these drugs, but I could not afford it. She said this triple combination is how they did it back before all the biologics came out. Sadly, all three of these meds were not helping at all so I just recently started on Enbrel. Now I am only on methotrexate and the Enbrel. Hopefully I will start feeling better soon.
Just wanted to mention to you that it is very important to keep up with getting your eyes checked. The Plaquenil is the one medication that can cause your eyes to get bad. Hopefully your doctor is having you go to an ophthalmologist not an optometrist, to get a baseline and then have them checked each year. The eye doctor said some people can only be on it for about 5 years. I guess back in the day, patients took very high doses and that is what caused eye problems. Now your dose should go by your weight. It should be Prescribed mg/kg.

I totally understand how you feel about the methotrexate. I feel the same way, but it has been used for many many years. When started early the research shows it helps keeping the joints from becoming damaged.

Good luck with everything!

Yes. If you feel good, dont take anything you dont want to. Doctors push pills without even realizing. Or maybe they do but they are so used to it they dont know any different.

I break my methotrexate up. I take 5 in the afternoon and 5 at bedtime. I don't have any problems with the methotrexate. The first RA doctor I went to had me on 5 folic acid every day. The RA doctor I see now said that would not do anything and now I take 1 folic acid every day even on methotrexate day. In my post to you earlier I think I misspoke...about the warm lime juice.....that is supposed to help with the liver function. Sorry about that.

Thank you so much! Your answer gave me some peace. He did tell me about the ophthalmologist and frequent bloodwork. Maybe I should start it and see how it goes. He has the methotrexate at 6 tabs once a week for me along with Folic acid every day except on the methotrexate day. Thank you!