I Have Problems With Liver And/Or Kidney Function. How Will That Affect The Drugs I Can Take For Rheumatoid Arthritis?

— -- Question: I have problems with liver and/or kidney function. How will that affect the drugs I can take for rheumatoid arthritis?

Answer: Patients with liver or kidney problems present a unique challenge to rheumatologists and other doctors that treat rheumatoid arthritis.

Patients with liver problems should probably not take methotrexate. And methotrexate is a very important drug in our armamentarium for treating rheumatoid arthritis. Patients with kidney problems can take methotrexate but it needs to be monitored very very closely.

Other medications such as sulfasalazine or hydroxychloroquine may be perfectly safe in patients with liver or kidney problems and can be used in that setting. They still need to be monitored fairly closely.

The newer biologic response modifiers, or biologic DMARDs can be used in this setting under certain circumstances. Again, it's very important that this be monitored very closely by your rheumatologist if you have any underlying liver or kidney problems.

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