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Rheumatoid Arthritis Medications List
Although there is no specific treatment for rheumatoid arthritis (abbreviated as RA) thus far, there are variousavailable medications in pharmacies that are designed to manage its symptoms and eventually improve thepatientï¿½s health.
Overall, rheumatoid arthritis medications may be grouped into distinct types, as described below. Your physiciancan recommend an appropriate treatment plan to manage inflammation and pain of the joints, and stop damage tothe joints. Depending on the specific case, the most effective treatment can be achieved through a combination ofthese options:
Nonsteroidal Anti-inflammatory Drugs or NSAIDs
Nonsteroidal Anti-inflammatory Drugs, otherwise known as NSAIDs, are effective in relieving pain and reducinginflammation, but donï¿½t function to protect the joints from further damage. NSAIDs hinder the human body fromproducing a substance called prostaglandins, which is primarily responsible for pain and inflammation.
Common NSAID examples are naproxen (Naprosyn, Aleve) and ibuprofen (Advil, Motrin). Other NSAIDs includeketoprofen (Orudis), etodolac (Lodine), meloxicam (Mobic), oxaprozin (Daypro), indomethacin, Celecoxib(Celebrex), diclofenac (Voltaren and Cataflam), nabumetone (Relafen), and piroxicam (Feldene).
NSAIDs are frequently prescribed as soon as a final rheumatoid arthritis diagnosis is made. But remember thatwhen consumed in excess doses for extended periods, these drugs can cause adverse side effects, like gastriculcers, stomach bleeding, as well as potential damage to the liver and kidney.
A different type of rheumatoid arthritis medication is corticosteroids. These medications restrain the immunesystem, ultimately managing inflammation.
Cortisone (Cortone), methylprednisolone (SoluMedrol, DepoMedrol), betamethasone (Celestone Soluspan),dexamethasone (Decadron), prednisolone (Delta-Cortef), triamcinolone (Aristocort), and prednisone (Orasone,Deltasone), are some of the most common corticosteroids.
While corticosteroids are successful in treating RA, they have been known to cause adverse side effects if used inextended periods. Some of these side effects include glaucoma, easy bruising, cataracts, thinning bones,diabetes, and excessive weight gain.
Given the risks of severe side effects, such medications are often only used as a temporary solution to curtailsudden RA attacks. The good news is that a single injection of corticosteroids will block joint inflammation lastingfor a long period of time.
DMARDs or Disease Modifying Anti-Rheumatic Drugs
DMARDs (Disease Modifying Anti-Rheumatic Drugs) pertain to a group of medications that act to inhibit theimmune system from attacking the joints, eventually impeding the progression of further joint damage. In RAtreatment, these medications are often used on top of other drugs for more effective results.
RA commonly causes permanent joint damage, which manifests at the onset. It is for this reason that mostphysicians would advise DMARD therapy soon after making a diagnosis. Individuals are most responsive toDMARDs during the early stages of rheumatoid arthritis. The sooner the drug is taken, the more beneficial it is forthe patient.
DMARD examples include methotrexate (Rheumatrex), cyclosporine (Sandimmune, Neoral), hydroxychloroquine(Plaquenil), gold salts (Aurolate, Ridaura, Solganal, Myochrysine), azathioprine (Imuran), penicillamine(Cuprimine), cyclophosphamide, minocycline, leflunomide (Arava), and sulfasalazine (Azulfidine).
While a number of DMARDs have been effective in rheumatoid arthritis treatment, the risks for severe side effectsis enormous. Long-term DMARD consumption may lead to toxicity of the bone marrow and liver, infections,allergies (particularly of the skin), and even autoimmunity.
Among the DMARDs previously listed, hydroxychloroquine has the lowest potential for triggering bone marrow &liver toxicity, and is thus considered as 1 of the safest DMARDs to use. The bad news is that hydroxychloroquineisnï¿½t a particularly powerful drug and is not potent enough on its own to curtail the symptoms of rheumatoidarthritis.
Conversely, methotrexate is considered to be one of the most powerful DMARD types in treating RA because ofseveral reasons. Methotrexate has been reported to effectively fight RA without causing liver and bone marrowtoxicity like the majority of DMARDs. Additionally, it has been proven effective and safe when used together withbiological agents, which are another classification of RA drugs discussed below. Therefore, methotrexatemedications are commonly recommended in combination with some biological agents if methotrexate fails toadequately treat the condition on its own. Then again, keep in mind that although methotrexate is not aspotentially unsafe as other DMARDs, it still has the ability to block the bone marrow or trigger hepatitis. In suchcases, getting regular blood tests are imperative to efficiently monitor the individualï¿½s condition, as well as tostop treatment at the first sign of problems.
Biological drugs, also known as biological agents, work to alleviate inflammation through different methods.
An example of how biological agents work is by blocking TNFs (tumor necrosis factors). Adalimumab (Humira),etanercept (Enbrel), and infliximab (Remicade) are some examples of TNF blockers.
Another way with which biological agents treat inflammation is by eradicating B cells. Rituxan (Rituximab), inparticular, fuses itself to B cells, thus killing them.
Further drugs that reduce inflammation in their own way are:
- tocilizumab (e.g. Actemra and RoActemra), functions by inhibiting IL-6 (interleukin)
- anakinra (Kineret), blocks IL-1 or interleukin 1
- abatacept (Orencia), which serves to block T-cells
You must consider that each biological drug has its own potential for side effects. The potential for side effectsmust be considered when giving it to any individual.
Salicylates reduce prostaglandins production. Prostaglandins are the cause of arthritis inflammation and pain. Oflate, salicylates have been generally replaced with NSAID, mainly due to the fact that salicylates cause adverseside effects, like damaging the kidney.
Pain Relief Medications
Finally, a variety of pain relief medications may likewise be taken in RA treatment. Some pain relief medicationsare acetaminophen (Tylenol) and tramadol (Ultram).
Even though pain relief drugs neither reduce inflammation nor prevent further joint damage, such drugs allow thepatient to feel more comfortable and eventually function better. It is because of this that pain relief drugs arecertainly worth mentioning.
Surgery as a Last Resort
If all these medications still prove ineffective, your doctor can recommend surgical treatment. Examples ofsurgical procedures meant to treat RA include tendon repair, synovectomy (i.e. joint lining removal), and jointreplacement surgery (i.e. arthroplasty), in which the damaged joint is replaced with prosthetic ones.
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