Many patients with rheumatoid arthritis require long-term oral medication. As the saying goes, “it’s a medicine with three toxins”, patients need to understand the possible adverse effects of these drugs while taking them. In the event of related discomfort or abnormalities, seek medical attention and adjust the treatment plan in a timely manner. 1, methotrexate Methotrexate is the drug of choice for the treatment of rheumatoid arthritis. Its common adverse reactions include: bone marrow suppression, liver damage, gastrointestinal reactions, stomatitis, oral ulcers. Therefore, if you experience gastrointestinal discomfort, mouth ulcers or abnormal blood count or liver function during methotrexate administration, you should consult a specialist as soon as possible to find out whether you need to adjust the dose or add symptomatic medication. Leflunomide Leflunomide and methotrexate have synergistic effects and are often used in combination. Adverse effects include gastrointestinal reactions, liver damage, bone marrow suppression and hair loss. When combined with methotrexate, bone marrow suppression and liver damage may be increased, so regular blood tests and liver function are required. 3. Hydroxychloroquine Hydroxychloroquine is a routine drug for rheumatoid arthritis treatment, with relatively mild effects and relatively few adverse reactions. However, a few patients may develop blind spots, fundus damage, and myocardial damage. Therefore, long-term oral hydroxychloroquine patients every six months to one year feasible fundus examination. 4. Salazosulfapyridine Salazosulfapyridine is often used in combination with other anti-rheumatic drugs. Generally start with small doses to reduce adverse reactions. Common adverse reactions include: allergic reactions, bone marrow suppression, hemolysis, liver and kidney function impairment, etc. Patients who are allergic to sulfonamide should not take it. 5, Ellamod Ellamod is a more recent use of anti-rheumatic drugs for the treatment of rheumatoid arthritis. Common adverse reactions include: liver damage, bone marrow suppression, gastrointestinal discomfort (such as loss of appetite, epigastric pain, etc.), skin pruritus, etc.. When combined with methotrexate or leflunomide, regular blood tests and liver function should be reviewed. 6.Botanical preparations used for the treatment of rheumatoid arthritis mainly include Radix Polygoni and Paeonia Generalis. The main adverse effect of Leigongduan polysaccharide is reproductive toxicity, which may lead to menstrual disorders and amenorrhea in women and a decrease in the number and vitality of sperm in men. Therefore, it should not be taken by women of childbearing age. The effects of total peony glucoside are relatively mild, with few adverse reactions. A small number of patients may experience an increase in the number of stools after taking the drug, and some experience diarrhea. There are individual differences in adverse reactions to the drug, but the chance of serious adverse reactions is relatively low. Therefore, you should not be afraid to take medication because of the possibility of adverse reactions. Patients should pay attention to observation while taking medication and follow up regularly according to the doctor’s arrangement to detect adverse reactions and adjust the treatment plan in time.