MONDAY, April 17, 2023 (HealthDay News) -- Arthritis is a common disease that causes pain and inflammation in different body joints, making it difficult to enjoy everyday tasks and physical activity.
Fortunately, there are many different medications for arthritis. Depending on what type of arthritis you have and its severity, an arthritis medication may help you manage pain and other symptoms. Here is a breakdown of the most common arthritis medications, how they work and their potential side effects.
The Arthritis Foundation lists the following as the medications used to treat arthritis:
- Analgesics including acetaminophen (Tylenol) and opioids
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Corticosteroids
- Disease-modifying antirheumatic drugs (DMARDs) including biologics and targeted DMARDs
Analgesics
The Arthritis Foundation reports that analgesics may help with mild to moderate pain, but they will not help with the inflammation associated with arthritis. Analgesics work in the nervous system and alter how your brain perceives pain. They can be used to treat the pain associated with any type of arthritis, although more effective options are available. Analgesics can be opioid, non-opioid or a combination.
Common analgesics are:
- Acetaminophen (Tylenol)
- Codeine
- Oxycodone
- Fentanyl
- Hydrocodone
Potential side effects:
- Kidney damage
- Liver damage
- Addiction
- Constipation
- Gastrointestinal bleeding
Use caution when taking these medications; take only as prescribed.
NSAIDs
NSAIDs work by blocking prostaglandin. According to the Cleveland Clinic, one role prostaglandins play is forming clots and causing inflammation at the site of an injury. NSAIDs are used to treat the pain and inflammation associated with rheumatoid arthritis and osteoarthritis.
Common over-the-counter (OTC) NSAIDs are:
- Aspirin (Bayer, St. Joseph, Anacin, Excedrin and more)
- Ibuprofen (Motrin, Advil)
- Naproxen sodium (Aleve)
Prescription NSAIDs are:
- Celecoxib (Celebrex)
- Diclofenac (Voltaren, available by brand name in topical form)
- Fenoprofen (Nalfon)
- Indomethacin (Indocin, available by brand name in liquid form)
- Ketorolac tromethamine (Toradol)
- Meclofenamate sodium (Meclomen)
- Diflunisal (Dolobid)
- Tolmetin (Tolectin)
- Ketoprofen (Orudis)
- Flurbiprofen (Ansaid)
Potential side effects of NSAIDs are:
- Increased risk of stomach and bowel issues like ulcers and bleeding
- Increased risk of stroke
- Heart problems
- Stomach pain
- Nausea
- Diarrhea/constipation
Corticosteroids
According to the Arthritis Foundation, corticosteroids mimic cortisol, a hormone your body produces naturally. They are used to treat inflammatory types of arthritis, including rheumatoid arthritis and psoriatic arthritis. They are great for short-term relief of inflammation but are not recommended for long-term use because of their side effects. Your doctor may prescribe a lower dose if you require them for long-term use.
Common corticosteroids:
- Prednisone (Deltasone, Prednicot, Cotolone)
- Prednisolone (Orapred, Omnipred)
- Cortisone (Cortone)
- Hydrocortisone (Cortef, Hydrocort)
- Triamcinolone (Aristocort)
- Dexamethasone (Decadron)
Common side effects of corticosteroids:
- Blood sugar spikes
- Weight gain
- Bone loss
- Risk of cataracts
- High blood pressure
- Infections
- Mood changes
DMARDs
The Arthritis Foundation says that DMARDs work with the body to “stop or slow the disease process in inflammatory forms of arthritis.” They work by blocking inflammation. There are many different DMARDs on the market, and they all have different ways of working in the body.
- Conventional DMARDs work by broadly suppressing the immune system. Often they are used in combination with other therapies.
- Targeted DMARDs block specific pathways inside immune cells.
- Biologic DMARDs are produced by live cells and work on specific immune proteins called cytokines.
Common DMARDs:
- Apremilast (Otezla)
- Baricitinib (Olumiant)
- Cyclophosphamide (Cytoxan)
- Cyclosporine (Gengraf, Neoral)
- Hydroxychloroquine (Plaquenil)
- Leflunomide (Arava)
- Methotrexate (Otrexup, Rasuvo, RediTrex)
- Mycophenolate mofetil (CellCept)
- Sulfasalazine (Azulfidine)
- Tofacitinib (Xeljanz, Xeljanz XR)
According to the Cleveland Clinic, common side effects of traditional DMARDs include:
- Loss of appetite
- Nausea
- Diarrhea
- Abdominal pain
- Rash, allergic reaction
- Liver problem
- Increased risk of infection
- Low blood cell counts
Common side effects of biologic DMARDs include:
- Increased risk of common and serious infections
- Reactivation of tuberculosis, herpes zoster, and hepatitis B and C
- Increased cholesterol levels, increased liver enzymes and low blood cell counts
- Increased risk of clotting
When prescribed DMARDs, inform your doctor of any other medications, including over-the-counter medicines, you are taking to avoid drug interactions. Some of these medications can cause teratogenicity (defects in a developing fetus.)
Writing recently in the Journal of the American Academy of Physician Assistants (JAAPA), physician assistant Michelle DiBiase and Dr. Samantha Kohn remind people that "The mainstay of pharmacologic therapy is early intervention with use of nonbiologic and biologic DMARDs together with adjunctive medications such as NSAIDs, oral and intra-articular corticosteroids, and analgesic medications, including opioids."
Your primary care provider or rheumatologist will work closely with you to determine which medications are best for your treatment. It is vital to keep them apprised of any side effects and let them know if the treatment is ineffective. They can work with you to find a treatment that helps relieve the pain and inflammation caused by arthritis.
