bruce , sorry to hear about your episode with Arava ,i have been using it most of this last year with no side effects . i didnt understand about the megadose tho . my regiment of drugs consists of 200 mg celebrex 2 times /day , 20 mg arava / day , 1 mg folic acid /day , tylenol ,tylenol-3 , + darvocet as needed . a year ago this time i was confined to the house and mostly to bed . hopefully you can find what works for you without much delay . keep looking up . we live by faith , not by sight ....Ed