Side Effect Solutions

DMARDs
DISEASE-MODIFYING ANTI-RHEUMATIC DRUGS

Without treatment, joint inflammation can cause permanent damage. Doctors know that it is wise to prescribe a disease-modifying antirheumatic drug (DMARD) before such damage occurs. People newly diagnosed with an inflammatory form of arthritis, such as RA, may be prescribed a DMARD upon their diagnosis.

Another reason DMARDs should be started early is that, although they are generally effective, they take a long time to show results. For example, hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine) may take up to three or four months before effects are noticed. Other drugs, such as methotrexate, work more quickly, but often not quickly enough. For that reason, doctors frequently prescribe an additional drug – such as a corticosteroid or an NSAID – to help control pain and inflammation while the DMARD starts to work.

DMARDs are most commonly used for RA, but some are also used for juvenile RA, ankylosing spondylitis, psoriatic arthritis and lupus. Some, such as chlorambucil (Leukeran), mycophenolate mofetil (CellCept) or cyclosphosphamide (Cytoxan), are used mainly to treat severe organ disease, such as kidney disease caused by lupus or vasculitis. The dosages listed in this chart are for those with RA; your dosage may vary depending on your specific condition and factors like disease severity, age, body weight and other medications you are taking.

Only three DMARDs – auranofin (Ridaura), leflunomide (Arava) and Azulfidine – were actually developed for RA. The others were borrowed from different areas of medicine: Hydroxychloroquine (Plaquenil) is a malaria drug, chlorambucil (Leukeran) and methotrexate are cancer medications and cyclosporine (Neoral) originally was developed to keep the body from rejecting transplanted organs.

Because DMARDs suppress the immune system, always watch for signs of infection – chills, fever, sore throat or cough – and report them to your doctor. And check with your doctor before getting any vaccinations.

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