Medications

Medications for arthritis include anti-inflammatory drugs to reduce swelling and medication to reduce pain and help with the functioning of the joints. Other disease-modifying anti-rheumatic drug (DMARDs) may be used to treat immune system problems.

Medications for short-term relief:

People with rheumatoid arthritis generally have pain caused by inflammation and often benefit from aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (e.g., Motrin® or Advil®).

Medications for long-term relief:

Disease-modifying anti-rheumatic drugs (DMARDs)

Disease-modifying anti-rheumatic drugs (DMARDs). These drugs are thought to influence and correct the abnormalities of the immune system that are responsible for diseases like rheumatoid arthritis. Treatment with these medications requires careful monitoring by a physician because of possible side effects.

Corticosteroids

These drugs reduce inflammation and can be very effective in treating arthritis, although they may also have significant side effects. Patients with rheumatoid arthritis may take prednisone by mouth or they may receive injections of corticosteroids directly into the affected joint. Since frequent injections may damage the joint cartilage, this procedure should be done only once or twice a year.

A word about NSAIDs

NSAIDs (nonsteroidal anti-inflammatory drugs) are commonly taken to reduce pain and swelling, although they are not for everyone. Ibuprofen, naproxen and aspirin are all NSAIDs. Talk to your doctor about whether taking NSAIDs is safe for you, especially if you:

• Have stomach bleeding or peptic ulcers.
• Have liver or kidney disease or a bleeding disorder.
• Drink more than three alcoholic drinks each day.
• Have high blood pressure or kidney, liver or heart disease.
• Take medicine for high blood pressure, aspirin to protect your heart or any sort of blood thinning drugs.
• Do not give aspirin to anyone younger than 20. It has been linked to Reye's syndrome, a serious illness. Do not give ibuprofen or naproxen to children without first talking to your health care provider.

Always read instruction labels carefully to understand all precautions.

COX-2 inhibitors

Recent information suggests that the COX-2 inhibitor celecoxib (Celebrex®) may increase the risk of heart attack and stroke. Related drugs, rofecoxib (Vioxx®) and valdecoxib (Bextra®), were removed from the market because of the risks of heart, stomach and skin problems. Ask your doctor if celecoxib is safe for you.

Other medications include:

Biologic response modifiers. These drugs selectively block parts of the immune system called cytokines, which play a role in inflammation.

Tumor necrosis factor inhibitors (etanercept, infliximab and adalimumab). These medications work well for people who don't have much luck with DMARDs. Your doctor may give you them along with some DMARDs, particularly methotrexate. Etanercept requires injections two times per week. Infliximab is injected into a vein during a two-hour procedure. Adalimumab requires injections every two weeks.

Interleukin-1 inhibitor (nakrina). This medication requires daily injections.

Patients can take acetaminophen or anti-inflammatory drugs for decades, providing they tolerate them well and only under a doctor's direction.

More on Rheumatoid Arthritis

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This article was reviewed and updated June 2007.