Methotrexate for rheumatoid arthritis dose it work and anyone had side effects?

Yes.: My colleagues believe it is the first choice (acr and eular), but while I use it as a second or third drug, the benefit/risk ratio is incredibly good. Methotrexate has little or no justification to be taken orally though. Unpredictable absorption, stomach concenbration build up, and going to the liver on first-pass! the liver sees 600x the ultimate concentration in the blood.