active infection, liver disease, known immune deficiency, renal insufficiency, or underlying malignancy. You will need regular blood tests, including liver
function tests. Leflunomide
must not be taken during pregnancy because it may cause birth defects in humans.
Methotrexate This drug can be taken by mouth or by injection and results in rapid improvement (it usually takes 3–6 weeks to begin working). It appears to be very effective, especially in combination with infliximab or etanercept.