Quick answer: Before starting a new arthritis medicine, ask what it is for, how and when to take it, how long it takes to work, what side effects to watch for, what monitoring you need, and what to do if you become ill. Ask about alcohol, other medicines, vaccines and pregnancy plans too. Write the answers down, and always follow your own team's advice rather than changing doses yourself.
Why it pays to ask questions
Starting a new medicine for arthritis can feel like a big step. Appointments are often short, there is a lot of information, and it is easy to go home and realise you forgot to ask something important. Knowing what to expect makes it more likely that the medicine will work well for you, that side effects are spotted early and that you feel in control.
You can ask these questions of your rheumatologist, specialist nurse, GP or pharmacist. Many rheumatology departments have an advice line for questions after you get home. Community pharmacists are also a great source of help and you do not need an appointment.
The 10 questions
1. What is this medicine for, and what should I expect it to do?
Some medicines, such as painkillers, ease symptoms. Others, such as DMARDs and biologics, change the course of the disease by calming inflammation and protecting joints. Understanding the goal helps you judge whether it is working. Our guide to arthritis medicines explained gives an overview of the main groups.
2. How and when do I take it?
Ask whether it is a tablet, injection or infusion, what time of day to take it, whether to take it with food, and what to do if you miss a dose. Some medicines, such as methotrexate, are taken once a week rather than daily, which is easy to get wrong, so make sure you are clear. If the dose will be increased gradually, ask for the plan in writing.
3. How long will it take to work?
Many DMARDs take weeks to a few months to reach their full effect. Knowing this stops you giving up too soon. Ask what you can do to manage symptoms in the meantime, and when the team will review whether it is working.
4. What side effects are common, and which ones are serious?
Ask which side effects often settle with time, what you can do to reduce them, and which symptoms mean you should get urgent help. For many immune-suppressing medicines, signs of infection, such as a fever or sore throat, need prompt attention. Ask whether there is anything you should report the same day.
5. What monitoring will I need?
Many arthritis medicines need regular blood tests, and some need blood pressure checks, eye tests or chest X-rays. Ask how often, where they happen and who checks the results. Find out whether your GP will share care with the hospital. A monitoring booklet or app can help you keep track.
6. Can I drink alcohol?
Some medicines, including methotrexate and leflunomide, can affect the liver, so you may be advised to keep alcohol low. Others have less of an interaction. Ask what limit is sensible for you. Our guide to arthritis and alcohol has more background.
7. Does it interact with my other medicines or supplements?
Bring a full list of everything you take, including over-the-counter painkillers, herbal remedies and supplements. Some combinations are unsafe or need extra monitoring. See our guides to medicine and supplement interactions and food, drink and arthritis medicines.
8. What about vaccines and infections?
Ask which vaccines you should have, ideally before you start, and whether any live vaccines should be avoided. Ask what to do if you get an infection, including whether you should pause the medicine. Only pause if your team tells you to. Our vaccines guide explains the basics.
9. What if I am planning a pregnancy or might become pregnant?
Some arthritis medicines are safe in pregnancy and breastfeeding, while others must be stopped well in advance, sometimes months before trying to conceive. This applies to some medicines for men too. Ask about contraception and planning, even if pregnancy feels a long way off. See our guide to arthritis and pregnancy.
10. Who do I contact if I have a problem, and how?
Ask for the rheumatology advice line number and its opening hours, and what to do out of hours. Find out who to call if you are struggling with side effects, have a flare, or need to reschedule monitoring. Save the number in your phone.
Other useful questions
- How long will I need to take it? Can the dose ever be reduced?
- Can I travel with it, and does it need to be kept in the fridge?
- Will it affect surgery or dental treatment?
- Is there support, such as a homecare service or an injection training session?
- What happens if it does not work?
Getting the most out of the appointment
- Write your questions down beforehand and put the most important ones first.
- Take someone with you if you can. A second pair of ears helps.
- Ask if you can make notes, or ask for written information.
- If you do not understand something, say so. It is fine to ask for it to be explained again in a different way.
- Ask for a copy of the clinic letter so you have a record of what was agreed.
If you feel worried about side effects or unsure about a medicine, it is always better to talk to your team than to stop taking it. Our guide to talking to your GP about medication worries and our guide to stopping arthritis medicines safely can help.
A note on doses
This guide deliberately does not give doses. The right dose depends on your condition, weight, kidney and liver function, other medicines and how you respond. Always take your medicine as your rheumatology team or prescriber has advised, and never change the dose yourself. If you think the dose is not right, contact your team.
Frequently asked questions
What should I ask before starting methotrexate?
Ask how and when to take it (it is usually weekly), when folic acid is taken, what blood tests you need, alcohol advice, which side effects to report, vaccines and pregnancy planning.
Who can I ask about my arthritis medicine after the appointment?
Your rheumatology advice line, your GP practice and your community pharmacist can all help. Pharmacists can answer many questions without an appointment.
How long should I try a new arthritis medicine before deciding it does not work?
Many DMARDs need two to three months or more to reach full effect. Your team will review progress and decide on next steps with you.
Is it safe to stop a medicine if I get side effects?
Contact your team first. Stopping suddenly can cause a flare, and there may be ways to manage the side effect. Get urgent help for serious symptoms.
Should I bring a list of my medicines to appointments?
Yes. Include prescribed medicines, over-the-counter products, herbal remedies and supplements, so interactions can be checked.
Sources and further reading
- NHS: Medicines A to Z
- NICE NG100: Rheumatoid arthritis in adults
- NICE NG197: Shared decision making
- BNF: British National Formulary
This guide is for general education and is not a substitute for personal medical advice. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.