Indications: moderate to severe active rheumatoid arthritis; active psoriatic arthritis.

Cautions: impaired bone-marrow function including anaemia, leucopenia or thrombocytopenia recent treatment with other hepatotoxic or myelotoxic disease- modifying antirheumatic drugs; washout procedures recommended for serious adverse effects or before switching to other disease-modifying antirheumatic drugs history of tuberculosis; exclude pregnancy before treatment; effective contraception essential during treatment and for at least 2 years after treatment in women and at least 3 months after treatment in men.

Contra-indications: severe immunodeficiency; severe hypoproteinaemia; serious infection.

Side Effects: diarrhoea, nausea, vomiting, anorexia, oral mucosal disorders, abdominal pain; increased blood pressure; headache, dizziness, asthenia, paraesthesia; leucopenia; tenosynovitis; alopecia, rash, dry skin, pruritus.

Dose: Rheumatoid arthritis, ADULT over 18 years, initially 100 mg once daily for 3 days, then 10–20 mg once daily.

Psoriatic arthritis, ADULT over 18 years, initially 100 mg once daily for 3 days, then 20 mg once daily.