Rheumatoid Arthritis Medications List

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Although there is no specific cure for rheumatoid arthritis (RA) at present, there are a range of available drugs being sold that are meant to manage its symptoms and in due course improve the condition.

Generally, rheumatoid arthritis medications may be categorized into different classes, as discussed below. Your physician will likely recommend an appropriate treatment plan to alleviate pain and inflammation of the joints, as well as avert further damage to the joints. Depending on each case, the most effective treatment can be accomplished through a combination of each of the succeeding drugs:

NSAIDs or Nonsteroidal Anti-inflammatory Drugs

Nonsteroidal Anti-inflammatory Drugs, abbreviated as NSAIDs, are effective in pain relief and inflammation reduction, but do not serve to protect the joints from further damage. Nonsteroidal Anti-inflammatory Drugs prevent your body from producing a substance called prostaglandins, which is primarily responsible for inflammation and pain.

Some examples of NSAIDs are naproxen (Aleve and Naprosyn) and ibuprofen (Motrin, Advil). Some more NSAIDs include ketoprofen (Orudis), etodolac (Lodine), meloxicam (Mobic), indomethacin, Celecoxib (Celebrex), oxaprozin (Daypro) diclofenac (Cataflam and Voltaren), piroxicam (Feldene), and nabumetone (Relafen).

NSAID medications are regularly advised as soon as a final diagnosis of RA is made. But remember that when taken in extreme dosages for a long time, these drugs can produce severe side effects, such as stomach bleeding, gastric ulcers, as well as potential damage to the kidney and liver.

Corticosteroids

Another classification of medication used for RA treatment is corticosteroids. Such medications suppress the immune system, thus managing inflammation.

Methylprednisolone (SoluMedrol, DepoMedrol), Cortisone (Cortone), betamethasone (Celestone Soluspan), prednisolone (Delta-Cortef), dexamethasone (Decadron), triamcinolone (Aristocort), as well as prednisone (Deltasone and Orasone), are some of the most common corticosteroids.

Although corticosteroids may be effective in treating RA, they have been said to trigger adverse side effects if used in prolonged periods. Examples of these side effects include easy bruising, glaucoma, cataracts, diabetes, excessive weight gain, and thinning bones.

On account of their potential to develop negative side effects, such medications are generally only used as a momentary solution to treat sudden rheumatoid arthritis attacks. The good news is that one single injection of corticosteroids is able to block inflammation of the joint for a long time.

Disease Modifying Anti-Rheumatic Drugs, a.k.a. DMARDs

Disease Modifying Anti-Rheumatic Drugs or DMARDs are a group of medications that serve to inhibit the immune system from damaging the joints, thus retarding further joint damage. When treating rheumatoid arthritis, these drugs are commonly taken on top of other meds for more successful results.

Rheumatoid arthritis causes permanent joint damage, which becomes apparent in the early stages. Accordingly, most physicians would prescribe DMARD therapy soon after an RA diagnosis. Individuals are most receptive to DMARDs in the early stages of rheumatoid arthritis. The earlier DMARDs are consumed, the more effective it is for the person.

Some DMARD examples are cyclosporine (Sandimmune, Neoral), hydroxychloroquine (Plaquenil), methotrexate (Rheumatrex), gold salts (Myochrysine, Ridaura, Aurolate, Solganal), penicillamine (Cuprimine), azathioprine (Imuran), cyclophosphamide, minocycline, leflunomide (Arava), and sulfasalazine (Azulfidine).

Even though various DMARDs have been effective in treating RA, the risks for severe side effects is high. Taking DMARDs for a long time may result in bone marrow and liver toxicity, vulnerability to infections, skin allergies, and autoimmunity.

Among the DMARDs mentioned above, hydroxychloroquine has the lowest risk of producing liver and bone marrow toxicity, and is hence believed to be one of the safest DMARD types to use. However, hydroxychloroquine is apparently not an especially powerful drug and is not strong enough on its own to control the symptoms of RA.

In contrast, methotrexate is deemed as one of the most powerful DMARDs to use in treating rheumatoid arthritis due to a number of reasons. Methotrexate has been proven to work in RA treatment without causing bone marrow and liver toxicity as in the majority of DMARDs. Additionally, methotrexate works safely and effectively when used together with biological agents, another classification of RA drugs discussed below. Consequently, these medications are frequently recommended for use with some biological agents if the drug fails to cure the disease on its own. On the other hand, please note while methotrexate is not as potentially unsafe as others, it still can obstruct the bone marrow or trigger hepatitis. In such cases, regular blood tests are always advised to efficiently monitor one's condition, as well as to cease treatment at the first hint of problems.

Biological Agents

Biological agents or biological drugs function to alleviate inflammation via various methods.

An example of how biological drugs work is by inhibiting tumor necrosis factors (TNFs). Etanercept (Enbrel), adalimumab (Humira), and infliximab (Remicade) are examples of TNF blockers.

Another example of how biological agents treat inflammation is through eradicating B cells. The Rituxan (Rituximab) drug, in particular, binds itself to B cells, ultimately killing them.

Further drugs that lessen inflammation in their own way are:

- tocilizumab (e.g. RoActemra, Actemra), works by blocking interleukin 6 or IL-6
- anakinra (e.g. Kineret), blocks IL-1/interleukin 1
- abatacept (Orencia), which works by inhibiting T-cells

Remember that each of these biological drugs has its own potential for negative side effects. A drug's side effects must be considered when giving it to any patient.

Salicylates

Salicylates function by reducing the body's production of prostaglandins. Prostaglandins are the cause of the pain and inflammation of arthritis. Of late, the use of salicylates have been generally replaced with NSAIDs, mainly due to the fact that the former cause adverse side effects, e.g. causing potential kidney damage.

Pain Relief Medications

Finally, a variety of pain relief medications can likewise be taken in rheumatoid arthritis treatment. Some pain relief medications are acetaminophen (Tylenol) and tramadol (Ultram).

While anti-pain drugs neither decrease inflammation nor suppress further joint damage, these medications allow the individual become more comfortable and eventually function better. Hence, anti-pain drugs are certainly worth considering.

Surgery as a Last Resort

If the medications previously listed still prove ineffective, your physician may probably recommend surgical treatment. Examples of surgical procedures used in rheumatoid arthritis treatment are tendon repair, joint lining removal (synovectomy), as well as arthroplasty (i.e. joint replacement surgery), wherein the damaged areas of the joint are replaced with prosthetics.



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