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He was treated for RA with infliximab (3 mg/kg) for 3 years, as well as methotrexate (20 mg/week), and corticosteroids. Leucovorin also is indicated as a rescue after high-dose methotrexate therapy in osteosarcoma and as a part of chemotherapeutic treatment programs in the management of several forms of cancer. Her RA had been treated with methotrexate (10 mg per week) and bucillamine (200 mg per day) for 6 years. It works like folic acid in the body, which helps to reduce the action and toxic effects of folic acid antagonists (eg, methotrexate). This indicates that NSAIDs may enhance the toxicity of methotrexate. Interstitial pneumonitis has been reported in a limited number of patients receiving infliximab concomitantly with a stable dosage of methotrexate. Leucovorin given at the appropriate time rescues bone marrow and gastrointestinal cells from methotrexate but has no apparent effect on pre-existing methotrexate nephrotoxicity. It is recommended that duration of leucovorin administration in these patients be based on determination of plasma methotrexate concentrations. Antibodies developed in 12% of patients on adalimumab monotherapy and in 1% of patients on concurrent methotrexate. His only other medications were amlodipine (5 mg per day) and methotrexate (15 mg per week).

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