I would use methotrexate before arava leflunomide , but that combination has been used very successfully.

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fear of side effects causes some primary care physicians who treat inflammatory arthritis to prescribe methotrexate in doses too small to provide adequate pain relief, says yusuf yazici, md, an assistant professor of medicine and colleague of chan s at the new york university school of medicine.

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with few major launches into the dmard class over the last five years the appearance of generic products, in particular methotrexate, has cut the cost of rheumatoid arthritis therapy.

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