Medications Used to Treat Rheumatoid Arthritis
Drug | Some Side Effects | Comments |
|---|---|---|
Many others | Upset stomach Increased blood pressure Kidney problems Possible increased risk of heart attack and stroke Possible increased risk of bruising and bleeding | NSAIDs treat some symptoms and decrease inflammation but do not prevent damage or alter the course of the disease. They are used less frequently now than in the past. These drugs are taken by mouth. Some NSAIDs are in cream form and can be applied to the skin directly over painful joints. |
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 | ||
Usually mild dermatitis (rash) and skin discoloration Muscle aches or weakness Rarely, cardiomyopathy Eye problems | All DMARDs can slow progression of joint damage as well as gradually decrease pain and swelling. These drugs are taken by mouth. | |
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 | ||
Numerous side effects throughout the body with long-term use:
| They may not be useful long term because of side effects. These drugs are usually taken by mouth but can be injected into a muscle (intramuscularly) or a vein (intravenously). | |
Rarely infection at the injection sites or within the joint Weakening of tissues if injections are given too frequently for too long Rarely, bleeding into the joint after injection, particularly in people taking anticoagulants (blood thinners) | These drugs are given by injection into a joint. | |
Potential risk of reactivation of infection (particularly tuberculosis and fungal infections) Skin cancers other than melanoma Reactivation of hepatitis B Occasionally systemic lupus erythematosus Demyelinating neurologic disorders (such as Guillain-Barré syndrome or multiple sclerosis) | These drugs are tumor necrosis factor (TNF) inhibitors. These drugs produce a dramatic, prompt response in most people. They can slow joint damage. | |
Lung problems Increased susceptibility to infection Headache Upper respiratory infection Sore throat Nausea | It may be given by vein (intravenously) or by injection under the skin (subcutaneously). | |
Pain, redness, and itching at injection site Increased risk of infection Neutropenia* | It is given by injection under the skin (subcutaneously). | |
When the drug is being given:
After the drug is given:
| It is given by vein (intravenously). | |
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 | ||
Infection (such as tuberculosis) may be serious or lead to sepsis Neutropenia* Possibly suppression of platelet production in the bone marrow, sometimes with increased susceptibility to bleeding Increase of liver enzymes Rarely perforation of the intestine | It may be given by vein (intravenously) or by injection under the skin (subcutaneously). | |
Janus kinase (JAK) inhibitors | ||
Risk of infection, particularly reactivation of chickenpox and shingles Nonmelanoma skin cancer High cholesterol levels (hypercholesterolemia) Major cardiovascular events (for example, heart attack, stroke) Lung cancer | It is taken by mouth. | |
Risk of infection, particularly reactivation of chickenpox and shingles Nonmelanoma skin cancer High cholesterol levels (hypercholesterolemia) Deep vein thrombosis (DVT) Major cardiovascular events (for example, heart attack, stroke) Lung cancer | ||
Risk of infection, particularly reactivation of chickenpox and shingles Nonmelanoma skin cancer High cholesterol levels (hypercholesterolemia) Venous thromboembolism Major cardiovascular events (for example, heart attack, stroke) Lung cancer | It is taken by mouth. | |
* Suppression of blood cell production in the bone marrow can lead to decreased numbers of infection-fighting white blood cells called neutrophils, increasing susceptibility to infection. | ||