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Its efficacy is similar to methotrexate in terms of signs and symptoms, and is a viable alternative to patients who have failed or are intolerant to methotrexate.

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elevated liver enzymes do not directly correlate with toxicity but therapy should be stopped and doses of methotrexate reduced if transaminases are elevated to 2 times the upper limit of normal.

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aspirin, asa severe caution should be exercised when salicylates are given in combination with methotrexate.

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taking them at the same time as methotrexate could increase the toxicity.

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onco docs say it normal and a side effect of the methotrexate.

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but on the methotrexate shots, which i find relatively painless to do, i get no side effects that i notice after about a year.

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