Treatment is usually initiated by a specialist, but GPs play an important role in monitoring patients for adverse effects and drug interactions. This article includes a pull out DMARD monitoring table and information on tumour necrosis factor (TNF) inhibitors. Plaquenil and prednisone together Hydroxychloroquine pmr The Combination of Leflunomide Arava and Methotrexate is Safe & Efficacious for the Treatment of Rheumatoid Arthritis April 13, 2005 By Arthritis Center Methotrexate MTX, an anti-metabolite that inhibits purine pathways, has been the hallmark of standard of care for many years in the treatment of rheumatoid arthritis RA. Hydroxychloroquine only* • Sulfasalazine at any dose • Prednisolone 10mg or less per day • Methotrexate 0.4mg/kg/week • Azathioprine 3mg/kg/day *GP should counsel patient that the risk of VZV reactivation is low 3. Vaccination contraindicated • Combination therapy not mentioned in the green box above. Sulfasalazine is a combination of sulfapyridine and aspirin like compounds. The medication may be associated with diminution in complete blood cell count. In general, one should consider withdrawal of the medication three or four days prior to surgery. Hydroxychloroquine is a less commonly utilized disease modifying anti-rheumatic medication. Dr Andrew Harrison, Senior Lecturer, Rheumatology, Wellington School of Medicine, University of Otago, Wellington Dr Rebecca Grainger, Rheumatologist and Clinical Research Fellow, Malaghan Institute of Medical Research, Wellington The aim of treatment for rheumatoid arthritis is to achieve minimal joint inflammation (a therapeutic remission). Key reviewers: Professor John Highton, Head of Section, Department of Medical and Surgical Sciences, Dunedin School of Medicine, University of Otago. Hydroxychloroquine methotrexate sulfasalazine azathioprine lefludomide DMARDs - NICE CKS, Considerations for patients aged 70-79 who are on DMARDs and. Plaquenil 200mg qdChloroquine malaria side effectsCan methrotrexate be taken with plaquenileHydroxychloroquine sun skin Background/Purpose The combination of methotrexate MTX, sulfasalazine SSZ and hydroxychloroquine HCQ triple therapy is a highly effective and well-tolerated treatment in rheumatoid arthritis RA. While MTX is the cornerstone of most successful combination therapies, not all patients are candidates for, or tolerate, MTX. Leflunomide, a disease-modifying anti-rheumatic drug DMARD. Leflunomide, Sulfasalazine and Hydroxychloroquine for.. A Guide To Perioperative Management Of The Rheumatoid.. Traditional DMARDs Methotrexate, Leflunomide.. Sulfasalazine enters breast milk in very small amounts. Use of the drug during lactation has been judged to be safe. 2 Azathioprine is excreted into breast milk and the manufacturer notes that the drug should not be used in nursing women. 2 Both methotrexate and leflunomide are contraindicated should not be used in women who are lactating. 2 Compare Methotrexate vs Sulfasalazine head-to-head with other drugs for uses, ratings, cost, side effects, interactions and more. Methotrexate rated 6.7/10 vs Sulfasalazine rated 5.7/10 in overall patient satisfaction. In Taiwan, several csDMARDs are available for RA patients including azathioprine, cyclosporine CS, hydroxychloroquine HCQ, leflunomide, methotrexate MTX, and sulfasalazine. MTX is the gold standard medicine for over 25 years in treating RA patients Negrei et al. 2016.