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Perform more frequent INR monitoring when starting or stopping other drugs, including botanicals, or when changing dosages of other drugs [see Drug Interactions (7)]

She had been diagnosed with RA (ANA+, RF+, CCP-) two years earlier and treated with renally dosed MTX (10 mg) weekly and daily folic acid supplementation with a 1 mg dose

Moving around can ease the uncomfortable sensations

If severe B12 deficiency with neurological involvement is suspected, treatment should be initiated promptly without waiting for test results, and specialist advice may be needed