Rheumatoid arthritis is a painful and incurable condition in which the body's immune system attacks the joints and sometimes organs. There are four general types of rheumatoid arthritis medication: analgesics, non-steroidal anti-inflammatories (NSAIDs), glucocorticoids, and disease-modifying anti-rheumatic drugs (DMARDs). These rheumatoid arthritis medications are often prescribed together to provide the patient with maximum relief. Each type of medication has its own side effects, some of which are quite serious.
Analgesics are used to decrease mild-to-moderate levels pain and are available over-the-counter and with a doctor's prescription. Acetaminophen, marketed as Tylenol®, may be purchased without a prescription. Side effects are uncommon, but taking too much of this drug may cause liver damage. Prescription analgesics include tramadol and oxycodone. Side effects may include dizziness, drowsiness, nausea, constipation, diarrhea, and increased sweating.
NSAIDs are used to reduce swelling and pain. They are available over-the-counter or with a doctor's prescription. Ibuprofen, marketed as Advil® and Motrin®, can be purchased without a prescription. Side effects may include abdominal cramps, dizziness, heartburn, nausea, vomiting, ulcers, and an increased risk of blood clots, heart attacks, and stroke. Celecoxib and diclofenac sodium, marketed as Celebrex® and Voltaren®, respectively, require a prescription. Diclofenac sodium's side effects are essentially the same as those that may be seen when taking over-the-counter rheumatoid arthritis medication; celecoxib's side effects may include a serious skin reaction, indigestion, diarrhea, or stomach pain.
Glucocorticoids are a type of steroid that reduces inflammation and blocks some immune responses. This category of rheumatoid arthritis medication is meant to decrease pain and slow, or even stop, damage to the joints and is available only with a prescription. They can be given as an injection or in pill form. Betamethasone, sold as Celestone®, and prednisone, sold as Deltasone®, should only be taken for short periods because both of them have extensive side effects. These drugs may cause bruising, cataracts, elevated cholesterol, hardening of the arteries, high blood pressure mood swings, weakness, osteoporosis, infections, and increased appetite.
DMARDs reduce inflammation and damage to the joints by disrupting immune cell production. These medications are usually started within three months of receiving the diagnosis of rheumatoid arthritis and may weaken the immune system, thus making users more susceptible to infections. It may take up to six months after beginning DMARDs before patients see any improvement in their condition. There are two classes of DMARDs: biological and oral.
Biologic DMARDs are administered via injection and can be expensive. Abatacept, sold as Orencia®, etanercept, marketed as Enbrel®, infliximab, sold as Remicade®, and rituximab, available under the name of Rituxan®, are all biological DMARDs. They may be used along with NSAIDs or glucocorticoids. Side effects may include chest pain, abdominal pain, headache, cough, or redness and pain at the injection site. The long-term effect of this class of rheumatoid arthritis medication is unknown.
Oral DMARDs are obtained with a prescription. They are provided in pill form. Cyclosporin, trade name Sandimmune®, methotrexate, sold as Rheumatrex®, and auranofin, marketed as Ridaura®, are all oral DMARDs. Potential side effects may include low blood counts, a metallic taste in the mouth, skin rash, high blood pressure, headache, kidney problems, chills, fever, liver problems, and light sensitivity.
