Rheumatoid Arthritis Medication
August 30, 2008 · Print This Article
Two classes of medications are used in treating rheumatoid arthritis: quick-acting first-line drugs, and slow-acting second-line drugs. The first-line drugs, such as aspirin and cortisone, are used to reduce inflammation and pain. Hydroxychloroquinine and methotrexate are slow-acting second-line drugs which promote disease remission and prevent progressive joint destruction.
Most patients require aggressive second-line drugs, such, as methotrexate in addition to anti-inflammatory agents. Sometimes these are used in combination. In some patients with severe joint deformity, surgery may be required.
First-line Drugs
Acetylsalicylate, ibuprofen, naproxen, etodolacare are examples of non-steroid anti-inflammatory drug. NSAIDs can reduce pain, swelling and tissue inflammation. Aspirin is an effective anti-inflammatory medication for rheumatoid arthritis. It has been used as rheumatoid arthritis medication since ancient times.
The most common side effects of aspirin and other NSAIDs include ulcers, abdominal pain, stomach upset, and sometimes even gastrointestinal bleeding. To reduce side effects on the stomach, NSAIDs are usually taken with food. Some additional medications are often recommended to protect the stomach from the ulcer effects of NSAIDs. These include antacids, proton-pump inhibitors, misoprotosol, and sucralfate.
Rheumatoid arthritis medications like cortisteroids can be injected directly into tissues and joints or be given orally. They are more potent than NSAIDs in reducing inflammation and in restoring joint mobility and function. They are useful for short periods during severe flares of disease activity, or when the disease is not responding to NSAIDs. Their side effects include facial puffiness, weight gain, thinning of the skin and bone, cataracts, risk of infection, muscle wasting, easy bruising and destruction of large joints such as the hips.
Second-line or slow-action Drugs
Rheumatoid arthritis requires medications other than NSAIDs and corticosteroids to stop increasing damage to cartilage, bone, and adjacent soft tissues. The rheumatoid arthritis medications are also referred to as Disease-modifying Anti-rheumatic Drugs or DMARDs. They come in many forms and are listed below.
Hydroxychloroquinine is used over extended periods as rheumatoid arthritis medication. Side effects include skin rashes, muscle weakness, upset stomach and vision changes. Though vision changes are rare, patients taking hydroxychloroquine should consult an ophthalmologist.
For the treatment of mild to severe inflammatory bowel diseases, like Crohn’s colitus and ulcerative colitus, sulfasalazine is a widely used oral medication. Azulfidine is used to treat rheumatoid arthritis in combination with anti-inflammatory medications. Azulfidine is generally well tolerated and side effects include rash and upset stomach. Azulfidine is made up of sulfa and salicylate compounds and it should be avoided by patients with known sulfa allergies.
Methotrexate has gained popularity among doctors as an initial second-line drug because of both its infrequent side effects and effectiveness. It also has dose flexibility. Methotrexate is an immune suppression rheumatoid arthritis medication. It affects the bone marrow and the liver, even rarely causing cirrhosis. Persons taking methotrexate require blood test monitoring regularly of blood counts and liver function blood tests.
Gold salts are a popular rheumatoid arthritis medication throughout most of the past century. Gold thiomalate and gold thioglucose are given by injection, initially on a weekly basis for long durations. Side effects of gold – both oral and injectable, include mouth sores, skin rash, kidney damage with seepage of protein in the urine, and bone marrow damage with anaemia and low white cell count. Patients receiving gold treatment are routinely monitored with urine and blood tests.
D-penicillamine can be a helpful rheumatoid arthritis medication in some patients with progressive forms of the disease. Side effects include fever, chills, mouth sores, a metallic taste in the mouth, skin rash, stomach upset, kidney and bone marrow damage, and easy bruising. Patients on this rheumatoid arthritis medication require routine blood and urine tests. D-penicillamine rarely causes symptoms of other autoimmune diseases.
A number of immunosuppressive drugs are used as rheumatoid arthritis medication. They include methotrexate as described above along with, chlorambucil, azathioprine, cyclophosphamide and cyclosporine. Because of rather serious side effects, immunosuppressive medicines are generally kept aside for patients with very aggressive forms of the disease, or those with serious complications. The exception is methotrexate, which is not frequently associated with serious side effects and can be carefully monitored with blood testing.
