Medications for Arthritis
Learn about the medicines you can use to treat arthritis and its symptoms.
Whether you have osteoarthritis, rheumatoid arthritis, psoriatic arthritis, or one of the nearly 100 other forms of arthritis and related diseases, you have plenty of medicines available to help. They can ease symptoms, slow the disease down and help you live a full and busy life. Some arthritis-related diseases — such as gout, fibromyalgia and osteoporosis — have medicines just for those diseases and are covered in our Drug Guide.
Here is a breakdown to help you sort out what is best for you.
General pain killers (analgesics) ease mild to moderate pain but don’t do anything for inflammation (hot, swollen joints). Acetaminophen (Tylenol) is available over the counter and is often used for arthritis because it doesn’t hurt your heart and stomach the way nonsteroidal anti-inflammatory agents (NSAIDs) can. But too much can harm your liver so you need to be careful about how much you take. Also watch out for combination products — such as cold, allergy or sleep medicines — that have acetaminophen plus other active ingredients.
Opioids are pain killers that must be prescribed by a doctor. They are very strong and can work well for severe pain. But they do have more side effects than acetaminophen and people can become dependent on them or addicted. Donald Miller, PharmD, Professor, Department of Pharmacy Practice at North Dakota State University in Fargo warns they are not much more useful for long-term use than acetaminophen or NSAIDs.
Medicines that contain both acetaminophen and opioids are also available.
Nonseroidal Anti-inflammatory Drugs (NSAIDs)
NSAIDs relieve pain and inflammation by blocking hormone-like substances called prostaglandins.
Naproxen (Aleve), aspirin and ibuprofen (Motrin, Advil) are available over the counter. Others like indomethacin (Indocin) and celecoxib (Celebrex) require a prescription.
NSAIDS can increase your chances of having a heart attack, stroke or a stomach bleed.
Corticosteroids, sometimes called steroids or glucocorticoids, reduce inflammation by acting like your natural hormone cortisol. They work quickly so are good for short-term relief. But they can create problems like weight gain, cataracts and high blood pressure. If you need to take them for a long time, your doctor will have you take only a small amount each day.
Traditional Disease-Modifying Antirheumatic Drugs (DMARDs)
DMARDs are used to slow or stop the inflammation that causes your joints and disease to get worse. They are an important tool for treating RA, ankylosing spondylitis, psoriatic arthritis, juvenile idiopathic arthritis and lupus. DMARDs weaken your ability to fight germs, so taking them raises your chances for getting infections.
It can take weeks or months for DMARDs to work. One DMARD might not do enough for you, so your doctor may combine two or three at a time. This is called combination therapy.
Methotrexate is the most well known and most used DMARD. It is usually the first drug your doctor will give you after you’ve been diagnosed with RA.
Biologics are a special type of DMARD. These powerful drugs work very well for many people with RA and other forms of inflammatory arthritis. They are harder to make than traditional DMARDs, so they can cost more than many of the medicines you may take. Some come as a shot that you give yourself and some have to be given in the doctor’s office through an IV (intravenous infusion). They weaken your ability to fight germs so you may get infections while taking biologics.
One biologic may work very well for some people, but not for others. A biologic may work for you at first, but then stop working after a while. If the first one you try doesn’t work for you, your doctor has other options.
There are five different types of biologics. Each works in a different way to stop what is making you sick.
- Anti-TNFs – also called TNF inhibitors or TNF blockers
- Interleukin-6 (IL-6) inhibitors
- Interleukin-1 (IL-1) receptor antagonists
- B-cell inhibitors
- Co-stimulation modulators
Unlike traditional DMARDs that slow your disease by holding down your body’s whole immune system, a few targeted DMARDs have come out that are more specific. These medicines are taken by mouth.
- Janus kinases (JAK) inhibitors: Your doctor may have you take this medicine if methotrexate doesn’t work for you.
- Phosphodiesterase 4 (PDE 4) inhibitors: Unlike other DMARDs, this medicine doesn’t increase your chance of getting a serious infection.