Medications for Arthritis


Welcome to Physical Therapy at Crossroads resource about Medications for Arthritis.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Uses of NSAIDs



NSAIDs can be very effective against inflammation, which can then lessen your pain and discomfort but they do not prevent tissue damage. Even when NSAIDs are controlling the inflammation, the joint or organ damage of arthritis can continue to get worse.

Complications of NSAIDs


Complications of NSAIDs

GI Effects

NSAIDs can irritate the gastrointestinal (GI) tract (the digestive system consisting of your esophagus, stomach, and intestines). They increase the production of gastric acid, and they harm the gastric lining. NSAIDs can aggravate ulcers and GI bleeding. Up to 5 percent of people who use NSAIDs for a year develop ulcers, bleeding, or tears in the GI tract. The risks are higher for older patients, patients with a history of GI problems, and patients with heart disease. Some prescribed NSAIDs, called COX-2 Inhibitors, act slightly differently in the body to affect inflammation, and for this reason, do not cause the GI symptoms often associated with NSAIDs such as aspirin, ibuprofen, or naproxen.

Blood Effects


Liver Effects


Kidney Effects


Other Effects



Uses of Corticosteroids


Corticosteroids are powerful drugs. They drastically decrease inflammation, but they are also highly toxic. Doctors have different opinions about how corticosteroids should be used.
Corticosteroids can't cure your disease. But they do seem to affect the progression of some diseases, including rheumatoid arthritis (RA).

Complications of Corticosteroids


The most common side effects are listed below.


All corticosteroids slow bone growth and create conditions that lead to osteoporosis, a disease process that results in reduction of bone mass. Compression fractures of the vertebrae as a result of osteoporosis can happen with long-term corticosteroid use. Women past menopause are most likely to develop osteoporosis. Your doctor may recommend that you take calcium and vitamin D supplements while you take corticosteroids.


High levels of corticosteroids hinder your body's ability to fight bacterial infections. High-dose corticosteroids can even mask the symptoms of some types of infections, such as abscesses and bowel tears. Most viral infections are not affected, except for herpes, which can sometimes worsen with the use of corticosteroids.

Adrenal Insufficiency

This means that your pituitary and adrenal glands can't produce adequate amounts of certain kinds of hormones. This can happen after taking corticosteroids in moderate doses for only a few days. Adrenal insufficiency is most likely to happen as you are reducing the dosage.  Adrenal insufficiency can be a problem if you need surgery or if you get an infection or serious injury.



Disease-Modifying Antirheumatic Drugs (DMARDs)

Uses of DMARDs


The idea behind using DMARDs is to prevent joint damage. This means you start using them early on, and you switch drugs or doses when your current drugs stop working. Using DMARDs requires you to be alert for possible side effects. You also need to be patient as DMARDs take time to work, but they can be very effective at slowing the course of your disease. DMARDs, however, do not cure disease. Very few patients see their disease go into a complete remission. Most patients find that their symptoms come back after months, or sometimes years of improvement on DMARDs.


Types and Complications of DMARDs


Antimalarial Drugs

Hydroxychloroquine and chloroquine have been used since the 1950s for rheumatic diseases but they have been used against malaria for much longer. These drugs are mostly used for RA and lupus.  Chloroquine has more side effects. Side effects include indigestion, rash, and eye problems. Antimalarial drugs take three to four months to show results.










This drug is most often used in RA, lupus, and other connective tissue diseases. It can also help offset the negative effects of steroids. Azathioprine is as effective as other DMARDs, but it also has more side effects. It can cause nausea, vomiting, diarrhea, bone marrow suppression, and hepatitis. The most troubling long-term side effect is cancer of the lymph system.

Nitrogen Mustard Alkylating Agents


Cyclophosphamide can be taken by mouth or intravenously. It is usually used to treat severe RA, lupus, and systemic vasculitis. Significant negative side effects are common. They include inflammation and bleeding of the ulcer, suppression of the immune system, reproductive problems in men and women, and cancer that may show up long after the drug is stopped.



Portions of this document copyright MMG, LLC.