90723, 1143 PM Rneumatold Artis Drug Guide: Types of Drugs, Uses, Side Elects [E) Rheumatoid arthritis Guide Vv Rheumatoid Arthritis Drug Guide a& Medically Reviewed by Jabeen Begum, wo on April 12, 2023 | Written by Annie stuart 13 minread Rheumatoid Arthritis Drug Types Rheumatoid arthritis (RA) is an inflammatory disease that affects the joints. It gets worse over time unless the inflammation is stopped or slowed. Only in very rare cases does rheumatoid arthritis go into remission without treatment. Skip to main content hitpsiwww.webmd.com/heumatoid-artatisheumatoie-athrtis-mecicaions, a79723, 1143 PM Rheumatoid Arhriis Drug Guide: Types of Drugs, Uses, Side Elects Doctors are more aggressive when they treat rheumatoid arthritis these days to stop or slow disease progression. This often means using multiple medications. Arthritis medications play an essential role in controlling the progression and symptoms of rheumatoid arthritis. Starting treatment soon after diagnosis is most effective. And the best medical care combines rheumatoid arthritis medications and other approaches. You may take rheumatoid arthritis medications alone, but they are often most effective in combination. These are the main types of RA medications: * Disease-modifying anti-rheumatic drugs (DMARDs) * Biologic response modifiers (a type of DMARD) * Glucocorticoids * Nonsteroidal anti-inflammatory drugs (NSAIDs) Skip to main content * Analgesics (painkillers) nips shwwn.webmetconvfteumatoid-arthrisrneumatoi-arthrits-madications an790723, 1143 PM Rneumatold Artis Drug Guide: Types of Drugs, Uses, Side Elects potent RA drugs for people who showed signs of joint damage. Today, doctors know that an aggressive approach is often more effective; it will result in fewer symptoms, better function, less joint damage, and less disability. The goal, if possible, is to put the disease into remission. Rheumatoid Arthritis Drugs: DMARDs If you've been diagnosed with rheumatoid arthritis, your doctor may recommend that you begin treatment with one of several types of DMARDs within a few months of diagnosis. One of the most important drugs in the arsenal for treating rheumatoid arthritis, DMARDs can often slow or stop RA from getting worse by interrupting the immune process that promotes. inflammation. But they may take up to 6 months to be fully effective. DMARDs have greatly improved the quality of life for many people with rheumatoid arthritis. These RA drugs are often used along with NSAIDs or glucocorticoids. But with this type of flammatories or analgesics. medication, you may not need other an Because DMARDs target the immune system, they also can weaken the immune system's ability to fight infections. This means you must be watchful for early signs of infection. In some cases, you may also need regular blood tests to make sure the drug is not hurting blood cells or certain organs such as your liver, lungs, or kidneys. Examples of DMARDs: Name Brand Name(s) | Precautions Potential Side Effects hydroxychloroquine sulfate | Plaquenil Tell your doctor if you + Blurry vision or have vision problems; visionmay increased light sensitivity be damaged with high doses or + Headache long-term use. + Belly cramps or pain + Loss of appetite, nausea, vomiting, or diarthea + Itching or rashes leflunomide Arava Tell your doctor if you panes Skip to main content have: + Headache — + Heartburn * Active infection + High blood pressure + Gastrointestinal or liver problems, hitpswuw.webmd.com/heumatoid-artntistheumatoie-arthrtis-mecicaions. a79723, 1143 PM Rheumatoid Aris Drug Guide: Types of Drugs, Stop taking leflunomide before trying to conceive. Uses, Side Effects methotrexate Rheumatrex, Trexall Tell your doctor if you have: . i + Abnormal blood counts Belly pain + Liver or ung disease : + Alcoholism: Active infection Chills or fever or hepatitis + Dizziness + Active plans to conceive : + Hair loss + Headache + Light sensitivity * Itching + Liver problems + Low blood counts Rare, but serious: Dry cough, fever, or trouble breathing, which may result from lung inflammation tofacitnib Xeljanz + Xeljanz adds to risk of serious | + Upper respiratory tract infections, cancers, lymphoma. infection + May increase cholesterol Headache levels and liver enzymes + Diarthea * May lower blood count + Inflammation of the nasal passage and the upper part of the throat + Blood clots and tears in the intestine bariitinib lumiant + Olumiant increases the risk of | = Upper respiratory tract Skip to main content serious infections, cancers, lymphoma. + May raise cholesterol levels and liver enzymes + May lower blood count nips shwwn.webmetconvfteumatoid-arthrisrneumatoi-arthrits-madications infection + Headache + Diarrhea + Inflammation of the nasal passage and the upper part of the throat + Blood clots and tears in the intestine an790723, 1143 PM Rneumatold Artis Drug Guide: Types of Drugs, Uses, Side Elects cancers. + Nausea + May cause blood clots + Tears in the stomach and intestines are possible. Minocycline (Minocin) is an antibiotic that is not often prescribed. But it may help RA by stopping inflammation. It can take several months to start working and up to a year before the full effects are known, When taken for long periods, minocycline can discolor the skin. Are DMARDs Safe? Many people take DMARDs without ever having problems. But because they work throughout the body to fight RA, their powerful action typically does cause some side effects, commonly: * Stomach upset. DMARDs sometimes cause nausea, sometimes with vomiting, or diarrhea, Other medicines can help treat these symptoms, or they often improve as you get used to the drug. if the symptoms are too uncomfortable to tolerate, your rheumatologist will try a different medication. * Liver problems. These are less common than stomach upset. Your doctor will check blood tests on a regular basis to make sure your liver is not being harmed. * Blood problems. DMARDs can affect the immune system and raise the risk of infection. Infection-fighting white blood cells may also be decreased, Low red blood cells (anemia) can make you feel tired more easily. A simple blood test by your doctor every so often will make sure your blood counts are high enough. You should learn about possible side effects of any medicine you are taking and discuss them with your doctor until you feel comfortable. To lessen side effects, DMARDs are sometimes started one at a time and increased gradually. The goal is to lessen both rheumatoid arthritis disease activity and medication side effects. It often takes more than one DMARD to get control of active rheumatoid arthritis. Skip to main content Rheumatoid Arthritis Drugs: Biologic Response Modifiers hitpsiwww.webmd.com/heumatoid-artatisheumatoie-athrtis-mecicaions, 579723, 1143 PM Rheumatoid Arhriis Drug Guide: Types of Drugs, Uses, Side Elects condition and help relieve symptoms. These RA medications can't cure rheumatoid arthritis. If the drugs are stopped, symptoms may return. But just as with other DMARDs, biologic response modifiers may slow the progression of the disease or help putit into remission, If your doctor prescribes one of these RA drugs, you will likely take it along with methotrexate. Biologic response modifiers are taken by injection and/or by IV and are expensive. Their long-term effects are unknown. NOTE: Before taking biologics, it's important to get the vaccinations you need and to be tested for tuberculosis and hepatitis B and C. Examples of biologic response modifiers: Name Brand Name | Precautions Poter abatacept —_Orencia + Tell your doctor if you have a serious + Cough infection, such as pneumonia or COPD. + Dizziness + Do not take lve vaccines. + Headache + Get tested for TB and hepatitis before | Serious infection starting treatment. “WV reaction + Serious infections, lke TB, and infections from bacteria, viruses, or fungi ‘adalimumab Humira + Tell your doctor if you have a serious + Redness, pain, itching, or bruising infection, such as pneumonia. where you got the shot + Do not take lve vaccines. + Upper respiratory infection + Get tested for TB and hepatitis before | Serious infections, like TB, and starting treatment. infections from bacteria, viruses, or fungi adalimumab- Amjevita, a + Tell your doctor if you have congestive | « Reactions where you got the shot atto biosimilarto | heart failure + Upper respiratory infections Humira + Your doctor should test you for + Rash tuberculosis and hepatitis. + Headaches + Serious infections, such as tuberculosis and sepsis, and infections from bacteria, viruses, of fungi + Higher risk for lymphoma and other cancers anakinra Kineret + Tell your doctor if you have a serious + Redness, swelling, pain, or bruising Skip to main content infection or a history of it * Do not take live vaccines, nips shwwn.webmetconvfteumatoid-arthrisrneumatoi-arthrits-madications Where you got the shot + Low white blood cell count + Upper respiratory infection + Serious infections, ike TB, and infections from bacteria, viruses, or fungi en790723, 1143 PM Rneumatold Artis Drug Guide: Types of Drugs, Uses, Side Elects ave congestive neart ranture, and tell your doctor if you have: + Diabetes, HIV, or a weakened immune system + Hepatitis B, or you have had it + Been exposed to TB + A serious nervous system disorder Do not take live vaccines. ‘swelling, or bruising at injection site + Headache + Rashes + Nausea + Fatigue + Belly pain Rare complications: + Higher risk of malignancy + Neurological events + Increased risk of serious infections, ike TB, and infections from bacteria, viruses, or fungi etanercept: stan Erelzi, a biosimilar to Enbrel Skip to main content Do not take if you have congestive heart failure, and tell your doctor if you + Have diabetes, HIV, or a weakened immune system + Have or have had hepatitis B + Have been exposed to TB + A serious nervous system disorder Do not take live vaccines. hitpsiwww.webmd.com/heumatoid-artatisheumatoie-athrtis-mecicaions, + Redness, pain, itching, swelling, or bruising at injection site « Headache * Rashes + Nausea + Fatigue + Belly Pain Rare complications: + Higher risk of malignancy + Neurological events + Increased risk of serious infections, ike TB, and infections from bacteria, viruses, or fungi m79723, 1143 PM Rheumatoid Arhriis Drug Guide: Types of Drugs, Uses, Side Elects concomitant immunosuppressants such as corticosteroids or methotrexate + Do not shake before administering + Rasnes + Nausea + Fatigue + Belly pain + Fever + Itching Rare complications include increased risks for: * Development of tuberculosis + Invasive fungal infections + Malignancies Infliximab-—-Renflexis + Tell your doctor if you have a serious . abda infection or a history of it Headache + Tell your doctor if you are taking + Rashes concomitant immunosuppressants such as corticosteroids or methotrexate + Nausea + Do not shake before administering + Fatigue + Belly pain + Fever + Itching Rare complications include: + Development of tuberculosis + Invasive fungal infections * Malignancies infiximas- | Inflectra + Tell your doctor if you have a serious + Headache yb infection or a history of it + Tell your doctor if you are taking + Rashes concomitant immunosuppressants such as corticosteroids or methotrexate + Nausea + Do not shake before administering Skip to main content * Fatigue + Belly pain ‘nips: shwwn.webme.convmieumatoid-arthristneumatoi-arthrits-madications an79723, 1143 PM Rheumatoid Arhriis Drug Guide: Types of Drugs, Uses, Side Elects Rare complications include increased risk for: + Development of tuberculosis + Invasive fungal infections + Malignancies rituximab Rituxan rituximab: Truxima abs Skip to main content + Tell your doctor if you have a serious infection, or heart or lung disease. + Tell your doctor if you are taking immunosuppressants such as methotrexate or corticosteroids. + Tell your doctor if you have a serious infection, or heart or lung disease. + Do not take lve vaccines. ‘nips: shwwn.webme.convmieumatoid-arthristneumatoi-arthrits-madications + Belly pain * Chills or fever + Headache * Infection Itching Serious side effects: + IV reactions + Tumor lysis syndrome + Severe skin reactions + Increased risk of serious infections, like TB, and infections from bacteria, viruses, or fungi + Belly pain + Chills or fever + Headache + Infection “Itching Serious side effects: + IV reactions Tumor lysis syndrome + Severe skin reactions + Increased risk of serious on79723, 1143 PM Rheumatoid Arhriis Drug Guide: Types of Drugs, Uses, Side Elects viruses, or fungi rituximab-—-Ruxience + Tell your doctor if you have a serious : pwr infection, or heart or lung disease. Belly pain + Do not take live vaccines. * Chills or fever + Headache + Infection + Itching Serious side effects: *IV reactions + Tumor lysis syndrome * Severe skin reactions + Serious infections, like TB, and infections from bacteria, viruses, or fungi infliximab Inflectra, a + Do not take this medicine if you have + Diarthea yb biosimilarto | moderate to severe heart failure + Headache Remicade + Tell your doctor if you have had + Fatigue tuberculosis or hepatitis + Nausea + Rash atthe IV site + Upper respiratory infections. + Urinary tract infections + Tuberculosis + Sepsis + Fungal infections golimumad | Simp oni “Tell your doctor if you have any infections | Simponi or health conditions, like heart disease, Redness where you got the MS, or diabetes shot Simponi + Get tested for TB before starting Aria Skip to main content treatment, + Do not take live vaccines. + See your doctor right away if you have signs of an infection while taking this drug ‘nips: shwwn.webme.convmieumatoid-arthristneumatoi-arthrits-madications + Upper respiratory infections * Nausea + Abnormal liver tests Rare complications: + Higher risk of serious infections, like TB, and infections from bacteria, 1017911723, 1143 PM Rheumatoid Arhriis Drug Guide: Types of Drugs, Uses, Side Elects hepatitis B infection + Lupus + Multiple sclerosis, certolizumab —Gimzia + Tell your doctor if you have an infection | « Nerve problems such as MS pegol or are being treated for an infection, orf «Allergic reactions you have diabetes, HIV, hepatitis B, cancer, + Autoimmune problems like lupus orTB, + Reactivation of hepatitis B + Serious infections, lke TB, and infections from bacteria, viruses, or fungi tocilizumab —Actemnra + Tell your doctor if you have a serious + Upper respiratory tract infection infection, history of gastrointestinal + Inflammation of the nose or throat perforation, orif you are pregnant or plan + High blood pressure on becoming pregnant + Headache Do not take live vaccines. + Abnormal liver enzyme level + Increased risk of serious infections, like TB, and infections from bacteria, Viruses, of fungi sarilumab —Kevzara + Upper respiratory tract infection + Tell your doctor if you: + Have had TB, or if your immune system is weakened by conditions such as diabetes, hepatitis, or HIV + Are being treated for an infection + Plan on becoming pregnant. + Urinary tract infection + Nasal congestion + Sore throat + Runny nose + Redness where you got the shot To. . Skip to main content Several man-made steroids calls corticosteroids help relieve RA symptoms and may stop or -inflammatory drugs that can also block other immune responses. slow joint damage. You receive these RA drugs by pill oras a shot. nips shwwn.webmetconvfteumatoid-arthrisrneumatoi-arthrits-madications 79723, 1143 PM Rheumatoid Arhriis Drug Guide: Types of Drugs, Uses, Side Elects effective. If your side effects are severe, don't stop taking the drug suddenly. Talk first with your doctor about what to do. Examples of corticosteroids: Brand Potential side Name Name(s) | Precautions _Effects Celestone Tell your doctor | + Bruising betamethasone if you have: + Cataracts + Fungal “Increased injectable infection cholesterol “History of TB | + Atherosclerosis *Underactive | + High blood thyroid pressure + Diabetes + Increased + Stomach ulcer | appetite or * High blood indigestion pressure + Mood swings ot + Osteoporosis nervousness * Muscle weakness + Osteoporosis: + Infections prednisone Rayos Tell your doctor + Bruising if you have: + Cataracts + Fungal + Increased infection cholesterol sHistory of 18 | «Atherosclerosis + Underactive * High blood thyroid pressure + Diabetes * Increased Stomach ulcer | appetite or * High blood indigestion pressure + Mood swings or “Osteoporosis | nervousness * Muscle weakness + Osteoporosis + Infections methylprednisolone | Medrol + Upset stomach Tell your ‘stomach doctor if you | ititation h “Yomiing js i 7 Headache Skip to main content lave: “Trouble sleeping A + Depression +Skinrash | anwety . + Hair growth Swollen | 253) nips shwww.webmelconvmeumatoid-arthriisneumatol-arthrts-madications 12790723, 1143 PM Rneumatold Artis Drug Guide: Types of Drugs, Uses, Side Elects ankles + Trouble seeing *Acold or infection that lasts a long time + Weak muscles + Black poop Rheumatoid Arthritis Drugs: NSAIDs NSAIDs work by blocking an enzyme that promotes inflammation. By reducing inflammation, NSAIDS help reduce swelling and pain. But they are not effective in reducing joint damage. These drugs alone are not effective in treating the disease. They should be taken along with other rheumatoid arthritis medications. As with glucocorticoids, you should use them for brief periods - they can cause severe digestive tract problems. Which type, if any, your doctor prescribes may depend on your medical history. If you have a history of stomach ulcers or liver, kidney, or heart problems, it's best to not take these drugs. Ask your doctor if any new NSAIDs with fewer side effects are available. Examples of NSAIDs: Brand Potential Side Name Name(s) Precautions | Effects ~ tebrex + Tell your doctor | + Increased risk of Skip to main content if you have had a heart attack, stroke, angina, blood clot, or high blood heart attack and stroke + Indigestion, diarthea, and stomach pain hitps www. webmd.com/heumatoid-artatisheumatoie-arthrtis-medicaions, 1317911723, 1143 PM Rheumatoid Arhriis Drug Guide: Types of Drugs, Uses, Side Elects NSAIDs or sulfa drugs. Do not take with other NSAIDs. + Do not take late in pregnancy. diclofenac sodium | Voltaren Tell your + Belly cramps, y diarrhea doctor if you: | ~ Dziness or drowsiness, * Drink + Heartburn, indigestion, alcohol nausea, vomiting, ulcer, or bleeding *Use blood | « increased risk of blood clots heart thinners attacks, and “Take ACE | stroke + Greater risk of inhibitors, complications for people with lithium, cardiovascular , disease warfarin, or furosemide + Have Skip to main content ibuprofen ‘Advil, Motrin sensitivity to aspirin; kidney, liver, or heart disease; asthma; high blood pressure; or ulcers Do not take with other NSAIDs. Tell your doctor if you: + Drink alcohol + Higher risk of heart attack and stroke nips shwwn.webme:convfteumatoid-arthrisrneumatoi-arthritis-madications 187911723, 1143 PM Rheumatoi Rheumatoid Arhriis Drug Guide: Types of Drugs, Uses, Side Elects inhibitors, lithium, warfarin, or furosemide Have sensitivity to aspitin; kidney, liver, or heart disease; asthma; high blood pressure; uloers *Do not take with other NSAIDs. drowsiness. + Heartburn, indigestion, nausea, vomiting, Ulcer, of bleeding + Increased risk of blood clots, heart attacks, and stroke + Greater risk of complications for people with cardiovascular disease Arthritis Drugs: Analgesics Analgesics reduce pain, but they do not reduce swelling or joint damage. There are a variety of over-the-counter and prescription analgesics. Narcotics are the most powerful type of analgesic. Use these carefully, and be sure to let your doctor know if you have any history of alcoholism or drug abuse. Examples of analgesics: Brand Potential Side Name Name(s) | Precautions | Effects acetaminophen | Tylenol, + Tell your doctor | Side effects Feveral ifyou have three | uncommon it cormore drinks | taken as ditected. of alcohol daily + Avoid taking more than one product with acetaminophen. tramadol Ultram + Tell your doctor | + Constipation Skip to main content nips shwwn.webme:convtteumatoid-arthrtisrneumatoi-arthritis-madications if you use central nervous system depressants, ‘tranquilizers, sleeping medications, muscle relaxants, or narcotic pain + Diarrhea + Drowsiness «Increased sweating + Loss of appetite + Nausea 151179723, 1143 PM Rheumatoid Arhriis Drug Guide: Types of Drugs, Uses, Side Elects or aloohol abuse =Do not stop suddenly or increase the dose on your own, *Do not drive or use heavy machinery until you know how your body reacts ‘to the drug. ‘oxycodone, hydrocodone, and other narcotics OxyContin, Roxicodone + Tell your doctor if you use central nervous system depressants, tranquilizers, sleeping medications, muscle relaxants or narcotic pain medications or if you have a history of drug or alcohol abuse + Never chew or cut tablets; @ high dose can be fatal if released rapidly. + Constipation + Dizziness + Drowsiness + Dry mouth + Headache + Increased sweating + Itchy skin + Nausea or vomiting + Shortness of breath Y_ Show Sources SOURCES: American College of Rheumatology: "Rheumatoid Arthritis." ‘Amgen Prescribing Information, Amjevita. Arthur Kavanaugh, MD, rheumatologist; professor of medicine, University of California at San Diego. Arthritis Foundation: "Drug Guide." ‘eMedicine Health: "Rheumatoid Arthritis." FRA: "Theranautice far Rheumatoid Arthritis. Medscape: "FDA Approves Orencia Simponi. FDA approves Inflectra, a biosimilar to Remicade. " Skip to main content on, Infliximab-dyyb (Inflectra}." "FDA approves Amjevita, a biosimilar to Humira.” nips shwwn.webmetconvfteumatoid-arthrisrneumatoi-arthrits-madications 167911723, 1043 PM Rneumatold Artis Drug Guide: Types of Drugs, Uses, Side Elects MedlinePlus: "Methylprednisolone.” View privacy policy, copyright and trust info NEXT ARTICLE How Does Methotrexate Treat Rheumatoid Arthritis? hitpsiwww.webmd.com/heumatoid-artatisheumatoie-athrtis-mecicaions, v7