Conventional synthetic disease-modifying antirheumatic drugs (DMARDs)

Usually mild dermatitis (rash) and skin discoloration (may be sensitive to sunlight)

Muscle aches or weakness

Rarely, cardiomyopathy

Eye problems

Rashes

Liver disease

Damage to nerves (neuropathy)

Diarrhea

Hair loss

Birth defects

Liver disease

Lung inflammation

Nausea

Neutropenia*

Mouth sores

Decreased sperm numbers and fertility in men

Hair loss

Birth defects and increased risk of miscarriage

Stomach problems

Neutropenia* (usually only when treatment begins)

Breakdown of red blood cells (hemolysis)

Liver problems

Rashes

Janus kinase (JAK) inhibitors

Risk of infection, particularly reactivation of chickenpox and shingles

Skin cancers other than melanoma

High cholesterol levels (hypercholesterolemia)

Major cardiovascular events (for example, heart attack, stroke)

Lung cancer

Venous thromboembolism (for example, deep vein thrombosis, pulmonary embolism)

Biologic DMARDs

Potential risk of reactivation of latent infection (particularly tuberculosis, hepatitis B, and fungal infections)

Skin cancers other than melanoma

Occasionally systemic lupus erythematosus

Demyelinating neurologic disorders (such as Guillain-Barré syndrome or multiple sclerosis)

Heart failure worsening

Lung problems

Increased susceptibility to infection

Headache

Upper respiratory infection

Sore throat

Nausea

Pain, redness, and itching at injection site

Increased risk of infection

Neutropenia*

When the medication is being given:

• Itching at injection site

• Rashes

• Back pain

• High or low blood pressure

• Fever

After the medication is given:

• Slightly increased risk of certain infections and possibly cancer

• Neutropenia*

• Reactivation of hepatitis B

  Rarely, progressive multifocal leukoencephalopathy

Neutropenia* (too few infection-fighting white blood cells)

Suppression of platelet production in the bone marrow, sometimes with increased susceptibility to bleeding

Increase of liver enzymes

Anaphylaxis

Rarely perforation of the intestine

Dyslipidemia (particularly elevated low-density lipoproteins [LDL])

Corticosteroids

Numerous side effects throughout the body with long-term use:

• Weight gain

• Diabetes

• High blood pressure

• Thinning of bones (osteoporosis)

• Death of bone due to poor blood supply (avascular necrosis)

• Cataracts

• Candidiasis, a fungal infection (oral or vaginal)

Corticosteroids, intra-articular injections

Rarely infection at the injection site or within the joint

Weakening and discoloration of the skin at injection site

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Many others

Upset stomach

Stomach ulcers and bleeding

Increased blood pressure

Kidney problems

Possible increased risk of heart attack and stroke

Possible increased risk of bruising and bleeding

Kidney problems

Increased blood pressure

Slightly less risk of stomach ulcer and bleeding than with other NSAIDs

Possible increased risk of heart attack and stroke