For millions of people arthritis drugs bring valuable relief, but they can also trigger adverse reactions that may cause patients to give up their medications. Abruptly stopping your medications can seriously undermine your treatment and long-term health, so it's essential to know how to fight common side effects of arthritis drugs.
Non-steroidal anti-inflammatory drugs
These over-the-counter (OTC) pain relievers—such as aspirin, ibuprofen and naproxen—are some of the most popular arthritis drugs for relieving pain and inflammation. They work by reducing the production of prostaglandins, which play a role in protecting the stomach lining from acid.
Common side effects: As a result, the most common side effects of NSAIDs are gastrointestinal problems such as stomach upset, bleeding or ulcers.
How to cope: Consider buying enteric-coated aspirin and ibuprofen. The Arthritis Foundation also recommends using an antacid, H2 blocker (such as Pepcid® or Zantac®), or proton pump inhibitor (such as Prilosec®) when taking NSAIDs to limit gastrointestinal problems.
Analgesics
Analgesics relieve pain but not inflammation, making them less effective as rheumatoid arthritis drugs and more effective for osteoarthritis. The most widely used analgesic is acetaminophen (Tylenol®).
Common side effects: Its most common side effect is liver damage when you take it over a long period or in large amounts. Liver damage is also a concern if you take acetaminophen with alcohol and other drugs that damage the liver.
To reduce the risk of liver damage, the Food and Drug Administration (FDA) panel recently voted to lower the maximum single dose of acetaminophen to 650 milligrams (mg), but the current single dose of Extra Strength Tylenol is 1,000 mg. They also recommended making the 1,000 mg dose of acetaminophen available by prescription only.
How to cope: Never exceed the prescribed dosage of acetaminophen. In light of the FDA recommendations, if you are taking a 1,000 mg dose, get advice from your doctor on the lowest effective dose to control your symptoms.
The American College of Gastroenterology also advises against taking acetaminophen with other drugs or herbs that can harm your liver including statins, "megavitamins," chaparral, comfrey tea, kava, skullcap, and yohimbe. If you drink don't take acetaminophen or acetaminophen combination drugs such as Percocet® or Tylenol3®.
Corticosteroids
These arthritis drugs, also known as glucocorticoids, are very effective at controlling inflammation and helping to prevent joint damage.
Common side effects: Prednisone and cortisone are the best known corticosteroids, but they produce common side effects that include osteoporosis, cataracts, weight gain, cataracts, diabetes and high blood pressure, according to the Arthritis Foundation.
How to cope: Researchers have found that low doses (5 mg or less) of corticosteroids taken over a long period of time offset many of the serious side effects. Consult with your doctor to ensure that you are taking the lowest dose to control your arthritis. Don't stop taking the drug on your own, however; the dose needs to be tapered to prevent other complications.
Disease-modifying antirheumatic drugs (DMARD)
Methotrexate (Trexall® or Rheumatrex®) is the most widely used and most effective DMARD for rheumatoid arthritis, according to the American College of Rheumatology (ACR). It relieves pain, reduces swelling and helps to prevent joint damage. When taking methotrexate many people don't experience adverse reactions, or they diminish over time, states the ACR.
Common side effects: Common side effects of methotrexate include nausea, vomiting, liver abnormalities, mouth sores, rash, diarrhea, lower blood cell counts, pneumonia, hair loss, and sun sensitivity.
How to cope: Take a lower dose. According to the ACR, many of the side effects such as nausea, vomiting, and liver abnormalities occur at higher doses. They also recommend taking folic acid to combat many of the side effects. Treat mouth sores with a mouth wash, and apply a sunscreen when you're heading outdoors.
If you experience hair loss or pneumonia, speak to your doctor about switching from methotrexate to another arthritis drug. Also, you should have a liver test every three months when taking this arthritis drug.
Biologic Response Modifiers
These rheumatoid arthritis drugs—such as Enbrel® and Humira®—work by modifying the immune system, hence the name. They're also known as biologics, cytokine inhibitors, or TNF inhibitors.
Common side effects: The most common side effects are higher risks of infections such as tuberculosis (TB) and pneumonia, and skin reactions at injection sites (for the injectable biologics).
How to cope: You shouldn't take biologics if you have a condition that makes you prone to infections, such as diabetes or HIV. Get tested for tuberculosis before beginning treatment with biologics. If you have TB, you'll have to stop taking biologics while the disease is being treated. If you develop an injection site reaction, your doctor may prescribe antibiotics, during which time you'll need to stop taking the biologics.
