Hi, I'm Lisa Emrich; RA Patient Advocate living with rheumatoid arthritis and multiple sclerosis. I'm here today to talk about when to consider switching RA medications. Please remember you always should consult your doctor. First off, what is a Disease Modifying Anti-Rheumatic Drug or called the DMARD. These are the medications which help to slow down the disease process. Early on, you may be focusing on inflammation and pain and getting those under control and you might need a course of steroids. But long term, you need a way to slow down the disease. When you first start a DMARD your really should give it time to start working. My rheumatologist told me that my first drug would take at least 2-3 months to really kick in. Some drugs may take longer, you know 4-6 months longer. Talk to your rheumatologist and ask how long they expect that it will take for the drug to kick-in and start working for you before you consider that it might not be working. And then, over time your needs may change. You may need to switch drugs because of insurance or perhaps you might want to start a family or other contributing factors. Perhaps the drug used to work great and then stopped working for you, and you may need to consider a change or perhaps consider adding a second or third drug of possibilities. And then if your side effects are too strong or if you have adverse events then you may want to consider switching. Adverse events are life threatening situations. They require medical intervention. They may be life threatening infections or cancer, or heart disease or neurological disorder or something pretty serious. And there are things that need to be reported to the FDA MedWatch program. You can do that directly or your rheumatologist can file a report for you. Then there may be common side effects including injection sites reactions, a flu-like symptoms or upper respiratory infections and those are things that you may want to consider. If they're too strong you might want to change medications. And that’s how I see it as an RA Patient Advocate. But I do recommend that you do reach out to your doctor for more details or go to Google and type in Switching RA Medications for more information. Thanks for watching.