| Medications | Side effects | Recommended monitoring |
| NSAIDs [84] | GI upset Gastritis Hepatotoxicity Nephrotoxicity | Symptoms check Periodic LFT and RFT |
| Corticosteroids [69] | Pulse doses Hypertension Hyperglycemia Behavioral changes Chronic use Diabetes Hypertension Osteopenia Obesity Skin: stria and acne Eyes: cataract and glaucoma Hypothalamic pituitary adrenal axis dysfunction | Periodic fasting serum glucose test Regular blood pressure measurement with each visit Annual lateral lumbar spine X-rays and DEXA scan if patient continues on CS more than one year Yearly eye exam by ophthalmologist for slit lamp examination and intraocular pressure measurement |
| Conventional DMARDs MTX [85] [111] Cyclosporine [87] [88] | MTX GI symptoms and gastritis Mucocutenous manifestations such as rash, mouth ulcers or alopecia Elevated transaminases Pneumonitis Leucopenia and thrombocytopenia Infection Cyclosporine Nephrotoxicity Hypertension GI symptoms: nausea, vomiting, diarrhea Elevated transaminases Headaches, tremor, seizure Gingival hyperplasia Hypertrichosis High lipid profile | MTX Baseline and periodic CBC, ESR, LFT, RFT, urinalysis Live vaccines are contraindicated Baseline varicella titres and MMR before treatment Cyclosporine Baseline and periodic creatinine, urea and electrolytes tests Lipid profile Monitor blood pressure |
| IL-I inhibitors (ankinra and canakinumab) [2] [5] [21] [76] [77] | Hypersensitivity reaction and can cause serious anaphylaxis Flare up of a LTBI Infections (herpes zoster, salmonella, coccidiose) Increase liver enzymes Thrombocytopenia | Periodic CBC, LFT, RFT and cogulation profile |
| Tocilizumab [22] [78] [79] [80] | Infections such as URTI and herpes reactivation Neutropenia (0.77 incident/patient-year) Hepatic toxicity (3.33 incident/patient-year) | Periodic CBC, LFT, RFT and coagulation profile |