The most widely studied and prescribed DMARD for RA is methotrexate. Others include hydroxychloroquine, leflunomide, and sulfasalazine, which may be used together with methotrexate or alone when methotrexate is not appropriate.

You may notice that methotrexate is commonly used in cancer therapies as well. However, the doses used to treat RA are much lower and will not produce the same effects as those seen in cancer treatments.

People taking methotrexate should also take a folic acid supplement (a vitamin in the Vitamin B family) as the drug depletes the body of this vitamin.

DMARD doses are adapted to your needs based on the severity of your symptoms and the stage of the disease. There is often a dose adjustment period in the early days of treatment. Your pharmacist will be there to assist you during this important time.

Each DMARD has its own dosing schedule that you must follow. Methotrexate, for example, is only taken once a week. The other DMARDs are usually taken on a daily basis.

DMARDs often come with specific instructions it is important to follow to ensure they act as effectively as possible and to reduce the risk of adverse side effects. For example:

• Avoid or reduce alcohol consumption
• Protect the skin from the sun
• Drink a lot of liquids during treatment

If you have questions or are having trouble following the instructions or the medication schedule, talk to your pharmacist.

Since it can sometimes take several weeks of treatment before the benefits of DMARDs are felt, your doctor may prescribe other medications to relieve residual pain or reduce inflammation until the DMARDs kick in completely.

Treatment for rheumatoid arthritis requires regular medical monitoring. It is crucial that you show up for your medical appointments and undergo the tests prescribed by your doctors, especially blood tests and eye examinations.

Your pharmacist plays an active role in this monitoring by ensuring that you tolerate your medications well and by recommending solutions to mitigate any adverse effects you may be feeling. He or she will also check that all your medications are compatible and will analyze your profile to avoid you taking a medication you may be allergic to or that could be unsuitable for you. This includes over-the-counter medications and natural health products, as DMARDs can interact with many products.

If your medications are due for renewal on different dates, ask your pharmacist to synchronize them, so as to avoid confusion and multiple trips to the pharmacy.

Rheumatoid arthritis is a progressive disease that requires close monitoring. Remember, you can count on your pharmacist’s support throughout your treatment.