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Methotrexate is sometimes given with plaquenal(SP). I have to take vicoden 500 three time a day. I also take Arava for RA. I have sjogrens,raynads,fibromyalgia,oseoarthritis. I still have some pain and then other times I have a lot of pain. That is when I take a prednisone boost. That helps get the pain under control.