Medications Used to Treat Rheumatoid Arthritis

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Prescription medications are among the best ways to manage rheumatoid arthritis. The goal of these drugs is to settle down the disease's activity in order to prevent permanent joint damage, and also to control pain and maximize function. Without medication, only a small minority of people will experience a quieting of inflammation and symptoms.

Several different types of medications can be used to treat rheumatoid arthritis. Which drugs your doctor prescribes will depend on the stage and activity level of your (or a loved one's) rheumatoid arthritis and any other health problems you might have.

Here are the most common types of medications used to treat rheumatoid arthritis:

Disease-modifying antirheumatic drugs (DMARDs)

DMARDs come in two key flavors, "nonbiologic" and "biologic," and are the mainstay of drug treatment for rheumatoid arthritis. They have the potential to prevent permanent damage to the joints, but they often take weeks to provide relief.

Commonly used nonbiologic DMARDs include methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide. Biologic DMARDs include etanercept, infliximab, and rituximab.

DMARDs almost always require careful monitoring for side effects. Read more about DMARDs here.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs include familiar over-the-counter drugs such as ibuprofen and naproxen; other NSAIDs, such as celecoxib, are only available by prescription.

Although NSAIDs do reduce inflammation, they aren't usually strong enough to counter the immune system's attack on the joints. Unlike DMARDs, NSAIDs don't delay or prevent permanent joint damage related to rheumatoid arthritis. For these reasons, NSAIDs are usually only used for extremely mild cases.

Side effects from NSAIDs are common, so older adults in particular should be monitored when taking NSAIDs every day.

Glucocorticoids

Also known as steroids, the most commonly prescribed oral glucocorticoids are prednisone and prednisolone. Glucocorticoids can also be injected into joints.

These drugs work quickly to suppress inflammation and pain and are often used for short-term symptom relief while waiting for a DMARD to take full effect. Although glucocorticoids are stronger anti-inflammatories than NSAIDs, they don't delay or prevent permanent joint damage in rheumatoid arthritis.

Furthermore, longer-term use of glucocorticoids usually causes problematic side effects in most people. These can include weight gain, diabetes, infections, and osteoporosis. For this reason, most people have their dose tapered down within weeks or months, and doctors generally strive to use the lowest dose possible.

Analgesics

These drugs help decrease pain but don't actually reduce inflammation in the body. Commonly used analgesics include acetaminophen, tramadol, and topical creams such as capsaicin. Occasionally, stronger opiate medications like hydrocodone or oxycodone may also be used.

Which medications should I be on?

Unfortunately, there's no easy answer to this question because treatment for rheumatoid arthritis is always tailored to the individual person. Things to consider:

  • The stage and activity of the RA

  • Potential side effects of the medications being considered

  • Medications you've tried in the past, and how well they worked

  • Other ongoing illnesses or chronic conditions

In general, most people with rheumatoid arthritis receive a disease-modifying antirheumatic drug (DMARD) as part of their treatment, since this is one of the best ways to prevent permanent damage to the joints.

For more on DMARDs, click here.

For ways to complement the medication treatment of rheumatoid arthritis, click here.


over 2 years ago, said...

It makes me sick, angry and depressed: My doctor diagnosed me with degenerative bone disease, however the VA says they don't know exactly what's wrong I done numerous MRIs, X-RAYS ,and even an EMG. Why can't they find the findings that My previous doctor found. Just sick and tired..


over 2 years ago, said...

the doctor gave me this pill call tramadol and i toke it 3 time a day and what could i do when it run out.


almost 3 years ago, said...

Could you get it from lifting at w ork


about 3 years ago, said...

I was recently diagnosed with arthritis in my back. The pain is in my hips. It started in one when doc told me i had it. 2 weeks later its in both hips. The pain is so severe i use a walker to walk or i will fall. I also get numbness in my feet and hands. The doctor gave me hydros. I dont want to depend on those forever. Any suggestions?


over 3 years ago, said...

Why is my rib cage so tight. What causes the pain around the rib cage?


about 4 years ago, said...

My lombar between 3 & 4 is full of Arhritis. I had a disk operation 14 months ago. Everything is OK at the disk level I had two steel bars installed to strengthen the disk, hence came the arthritis in the # 3 area. What can I take to reduce the pain in the lower back area? thanks


over 4 years ago, said...

I think it was fine just the way it was written. Although I have Diabetes and am having kidney problems & am unable to take ANY anti-inflammatory drugs the article was still helpful. There should be a little more space devoted to that exact problem possibly with advice of the best thing to do for the chronic pain.


over 4 years ago, said...

Quite by chance I came upon this article. As a retired health care professional I found it very informative, easy for lay people to read and understand. The article is quite good as it is, no need to gild the lily!


over 4 years ago, said...

In my long and storied medical history, I have found that the meds prescribed for one ailment usually cause other problems that then need to be treated with a different drug.. that in turn come with yet more problems. Leaving religious aspects out of the equation..the Earth has a cure for every ailment, cures that are side-effect free. Look to Nature..but be informed...don't take the word of some kid working the counter at the healthfood store...they come with their own biases and beliefs. I've lived in this body a long time and know it better than you, and I have a vested interest in the outcome! Physician Heal thyself, I'll take care of ME.


over 4 years ago, said...

I don't agree with taking medicine, it weakens your immune system and your bones. Its better to go the natural route like eating healthy, fish, vegetables and fruit, food high in antioxidants. Going to physical therapy, chiropractic, massage and exercising, stretching. I know to many people who have had problems with it, two aren't here anymore and one had hip surgery as a result of it and shes only 17.


over 4 years ago, said...

Have no comments at this time. Will use what I have received for a while and then we will see!