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Hi Sue,   You sound a bit nervous, so the first thing I'm going to say is Don't Worry! Many people do very well on methotrexate for years (I was one of them).  You can find more on methotrexate side effects here and here.  I'm not sure what an unacceptable liver function number is, but if you're not tolerating the drug well, there are many other options. They include Areva, Plaquenil and the biologic drugs like Enbrel and Humira. If arthritis treatments were stacked on a ladder, you're on one of the lower rungs - there are lots of places to go if methotrexate doesn't work for you. That said, it's quite likely that it will work for several years.   I suggest that you talk to your doctor about your concerns.  When I started methotrexate I was fairly freaked out myself, but when I'd been on it for a while, had several normal blood tests and more than one conversation with my doctor, I relaxed.  Taking big drugs can be frightening, but they do often allow you to get back to your life.   Good luck!