Don’t Have Enough Time, Here are the Key Points
- Rheumatoid Arthritis Medications: Common drugs include Leflunomide (Arava), Methotrexate (Trexall), Sulfasalazine (Azulfidine), and Minocycline (Minocin).
- Side Effects: Digestive issues, headaches, rashes, nausea, and liver problems.
- Osteoarthritis Medications: Frequently prescribed drugs are Celecoxib (Celebrex), Piroxicam (Feldene), and Oxaprozin (Ketoprofen ER).
- Side Effects: Heartburn, nausea, stomach cramps, dizziness, and potential kidney issues.
- Gout Medications: Probenecid (Probalan), Allopurinol (Zyloprim), Prednisone (Cortisone), and Colchicine are used for treatment.
- Side Effects: Digestive problems, rashes, liver complications, and higher infection risk.
- Patient Guidance: Patients are advised to understand these medications’ effects and discuss potential risks with their healthcare provider.
Introduction
Modern medicine has made great strides in treating arthritis. Yet many arthritis medications can cause unwanted side effects. These effects can impact your body, immune system, and gut health. Before starting any new medication, it’s important to understand these possible side effects.
Patient Experience
“When I was first diagnosed with rheumatoid arthritis, my doctor prescribed a medication without explaining the side effects. Within days, I felt nauseous and dizzy. I wish I had known what to expect.”
— Maria, 52, living with RA for 6 years
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Why Understanding Side Effects Matters
As we age, our medicine cabinets often fill with various prescriptions. Arthritis medications are common among these. Knowing the side effects of each medication helps you:
- Decide if the benefits outweigh the risks
- Know when to call your doctor about a reaction
- Plan for possible effects on your lifestyle
- Consider whether natural treatments might help your arthritis management plan
Benefits of Understanding Medication Side Effects
Make better decisions about treatment
Know when to call your doctor
Plan ahead for lifestyle changes
Consider natural alternatives
Types of Arthritis and Their Treatments
The medication you’re prescribed depends on the type of arthritis you have and its severity. The three most common types are:
- Rheumatoid Arthritis (RA) – When your immune system attacks your joints
- Osteoarthritis – From injury or wear and tear on joints
- Gout – From too much uric acid in your blood
Let’s look at common medications for each type and their possible side effect
Rheumatoid Arthritis Medications
Disease-Modifying Antirheumatic Drugs (DMARDs)
DMARDs slow down how RA damages your joints. They’re often the first line of treatment for RA.
1. Methotrexate (Trexall)
This is the most common DMARD. It was first used for cancer but in much lower doses for RA.
Common side effects:
- Upset stomach, nausea
- Mouth sores
- Fatigue
- Hair thinning
- Headaches
Less common but serious side effects:
- Liver damage
- Lung problems
- Lowered blood cell counts
“My doctor explained that the medication might cause stomach issues, but untreated arthritis could damage my joints permanently. This helped me make an informed decision.”
— Robert, 64, living with osteoarthritis
Managing side effects: Taking folic acid supplements can reduce many side effects of methotrexate. Your doctor will monitor your blood regularly to catch any serious problems early.
2. Leflunomide (Arava)
Common side effects:
- Diarrhea
- Hair loss
- Rash
- Liver problems
3. Sulfasalazine (Azulfidine)
Common side effects:
- Stomach upset
- Headaches
- Rash
- Sun sensitivity
- Reduced sperm count in men (temporary)
About 25% of patients have side effects from this medication.
4. Hydroxychloroquine (Plaquenil)
Common side effects:
- Upset stomach
- Headache
- Dizziness
- Rash
Less common but serious:
- Eye damage (rare with regular checkups)
DMARD Side Effects Overview
| Medication | Common Side Effects | Serious Side Effects (Less Common) | Special Notes |
|---|---|---|---|
| Methotrexate (Trexall) |
|
| Take with folic acid to reduce side effects |
| Leflunomide (Arava) |
|
| Not safe during pregnancy |
| Sulfasalazine (Azulfidine) |
|
| May reduce male fertility temporarily |
| Hydroxychloroquine (Plaquenil) |
|
| Needs regular eye exams; generally has fewer side effects than other DMARDs |
Biologics
Biologics are newer drugs that target specific parts of the immune system. They’re often used when DMARDs don’t work well enough.
Common side effects of all biologics:
- Increased risk of infections
- Injection site reactions (redness, pain)
- Headache
- Nausea
Serious but rare side effects:
- Serious infections
- Nervous system problems
- Heart failure (in those with heart disease)
- Possible increased risk of certain cancers
Common biologics include:
- Adalimumab (Humira)
- Etanercept (Enbrel)
- Infliximab (Remicade)
- Abatacept (Orencia)
- Rituximab (Rituxan)
JAK Inhibitors
These newer oral medications include tofacitinib (Xeljanz), baricitinib (Olumiant), and upadacitinib (Rinvoq).
Common side effects:
- Increased risk of infections
- Headache
- Upper respiratory infections
- Nausea
Serious but rare side effects:
- Blood clots
- Gastrointestinal perforations
- Serious infections
Osteoarthritis Medications
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs reduce pain and swelling. They come in over-the-counter and prescription strengths.
1. Celecoxib (Celebrex)
Common side effects:
- Heartburn
- Stomach pain
- Dizziness
- High blood pressure
2. Piroxicam (Feldene)
Common side effects:
- Stomach and intestinal problems
- Kidney issues
- Dizziness
- Headaches
- Ringing in ears
3. Over-the-Counter NSAIDs
These include ibuprofen (Advil, Motrin) and naproxen (Aleve).
Common side effects:
- Stomach upset
- Heartburn
- Increased risk of heart attack and stroke with long-term use
- Kidney problems
NSAIDs Side Effect Comparison
| Medication | Stomach Issues | Heart Risk | Kidney Risk | Other Side Effects |
|---|---|---|---|---|
| Ibuprofen (Advil, Motrin) | Moderate | Moderate | Moderate | Headache, dizziness |
| Naproxen (Aleve) | Higher | Lower | Moderate | Drowsiness, fluid retention |
| Celecoxib (Celebrex) | Lower | Moderate to high | Moderate | Headache, sinus inflammation |
| Piroxicam (Feldene) | Higher | Moderate | Higher | Dizziness, rash, tinnitus |
| Acetaminophen (Tylenol) (Not an NSAID) | Very low | Very low | Low | Liver damage (with high doses) |
Note: Individual responses may vary. Always consult with your healthcare provider.
Acetaminophen (Tylenol)
While not an NSAID, acetaminophen helps with pain but not inflammation.
Common side effects:
- Few side effects when taken as directed
- Liver damage with high doses or when mixed with alcohol
Gout Medications
1. Probenecid (Probalan)
This medication helps your body remove uric acid.
Common side effects:
- Headaches
- Upset stomach
- Frequent urination
- Loss of appetite
Not recommended for: People with kidney disease or kidney stones.
2. Allopurinol (Zyloprim)
Common side effects:
- Rash
- Stomach upset
- Decreased liver function
Important note: Don’t start allopurinol during an active gout flare—it can make it worse!
3. Colchicine
Common side effects:
- Diarrhea
- Nausea
- Stomach pain
- Disruption of gut health
4. Corticosteroids (Prednisone)
Common side effects with short-term use:
- Increased appetite
- Mood changes
- Trouble sleeping
- Fluid retention
Side effects with long-term use:
- Weight gain
- High blood pressure
- High blood sugar
- Bone thinning
- Increased risk of infections
- Cataracts
Short-term vs. Long-term Steroid Side Effects
Short-term Use
(Days to Weeks)
- Increased appetite
- Mood changes (irritability, anxiety)
- Trouble sleeping
- Water retention/puffy face
- Upset stomach
- Higher blood sugar levels
Most effects resolve after stopping the medication
Long-term Use
(Months to Years)
- Weight gain, especially around face and abdomen
- Thin, fragile skin that bruises easily
- Bone loss (osteoporosis)
- Increased risk of infections
- High blood pressure
- Diabetes or worsening of existing diabetes
- Cataracts and glaucoma
- Muscle weakness
Some effects may be permanent
Important Note
Never stop taking steroids suddenly. They must be tapered gradually under doctor’s supervision.
Understanding the Risk vs. Benefit Balance
When considering arthritis medication, it’s important to weigh the benefits against the risks.
“My doctor explained that the medication might cause stomach issues, but untreated arthritis could damage my joints permanently. This helped me make an informed decision.”
— Robert, 64, living with osteoarthritis
Questions to Ask Your Doctor
- What are the most common side effects of this medication?
- How likely am I to experience these side effects?
- Are there ways to reduce these side effects?
- What side effects should prompt me to call you right away?
- How will we monitor for serious side effects?
- Are there alternatives with fewer side effects?
Questions to Ask Your Doctor About Medication Side Effects
“What are the most common side effects of this medication?”
“How likely am I to experience these side effects?”
“Are there ways to reduce these side effects?”
“What side effects should prompt me to call you right away?”
“How will we monitor for serious side effects?”
“Are there alternatives with fewer side effects?”
Pro tip: Write down these questions before your appointment, and take notes on your doctor’s answers.
Natural Approaches to Managing Arthritis
Many people with mild to moderate arthritis symptoms find relief through natural approaches, either alone or in combination with conventional medicine.
Evidence-Based Natural Treatments
- Anti-inflammatory diet
- Emphasizes fruits, vegetables, fish, nuts, and olive oil
- Limits processed foods, red meat, and sugar
- A 2021 review of seven studies showed a significant reduction in pain and inflammation
- Exercise
- Low-impact activities like swimming, walking, and cycling
- Helps maintain joint function and reduce pain
- Strengthens muscles around affected joints
- Supplements with research support:
- Omega-3 fatty acids (fish oil)
- Turmeric/curcumin
- Glucosamine and chondroitin (for osteoarthritis)
- SAM-e (S-adenosylmethionine)
Patient Experience
“After dealing with medication side effects for years, I started an anti-inflammatory diet and gentle exercise program. I didn’t eliminate medications completely, but I was able to reduce my dosage with my doctor’s approval.”
— James, 58, living with osteoarthritis for 12 years
- Hot and cold therapy
- Heat for stiffness
- Cold for acute pain and swelling
- Mind-body approaches
- Meditation and stress reduction
- Tai chi and yoga (gentle forms)
- Studies show these can help manage pain perception
Natural Approaches to Arthritis Management
Anti-inflammatory Diet
- Eat more: Fruits, vegetables, fish, nuts, olive oil
- Eat less: Processed foods, red meat, sugar
- Evidence: Multiple studies show reduced inflammation
Exercise
- Best types: Swimming, walking, cycling
- Benefits: Maintains joint function, reduces pain
- Approach: Start slow and build gradually
Helpful Supplements
- Omega-3s: Reduces inflammation
- Turmeric: Natural anti-inflammatory
- Glucosamine: May help rebuild cartilage
- SAM-e: May reduce pain and inflammation
Mind-Body Approaches
- Meditation: Reduces stress and pain perception
- Tai Chi: Gentle movement with proven benefits
- Yoga: Improves flexibility and reduces stress
- Acupuncture: May help with pain management
Important: Always discuss natural approaches with your doctor, especially when taking medications.
Special Considerations for Different Patient Groups
| Patient Group | Special Considerations | Medications to Use with Caution |
|---|---|---|
| Older Adults (65+) |
|
|
| People with Heart Disease |
|
|
| People with Diabetes |
|
|
| Women of Childbearing Age |
|
|
| People with Kidney Disease |
|
|
Real-Life Management Strategies
Creating a Side Effect Management Plan
- Keep a symptom diary
- Track when side effects occur
- Note any patterns related to timing or other factors
- Bring this information to doctor appointments
- Timing matters
- Taking medications with food can reduce stomach upset
- Spacing doses properly can minimize side effects
- Stay hydrated
- Many medications require good hydration
- Water helps your body process and clear medications
- Regular monitoring
- Keep all lab test appointments
- Report new symptoms promptly
- Annual eye exams for those on hydroxychloroquine
When to Talk to Your Doctor About Changing Medications
- Side effects interfere significantly with your quality of life
- Lab tests show concerning changes
- You develop new symptoms that could be related to your medication
- Your arthritis symptoms aren't improving despite treatment
Conclusion
Only doctors should prescribe long-term medications for arthritis. However, being an informed patient is vital. Understanding potential side effects helps you work with your healthcare provider to find the best treatment plan for your unique situation.
For those with mild symptoms or early-onset arthritis, natural management methods may be beneficial alongside or instead of medications. People with advanced arthritis often need medication, but knowing the side effects helps you manage them better.
Remember: Never stop taking prescribed medication without talking to your doctor first. Work together to find the right balance between managing your arthritis and minimizing side effects.
Resources
- Arthritis Foundation – Comprehensive information on arthritis types, treatments, and lifestyle tips: https://www.arthritis.org
- American College of Rheumatology – Educational resources and guidelines on arthritis and rheumatic diseases: https://www.rheumatology.org
- Mayo Clinic – Arthritis Medications – Detailed descriptions of common arthritis medications and side effects: https://www.mayoclinic.org/diseases-conditions/arthritis/diagnosis-treatment/drc-20350774
- Creaky Joints - Patient-focused information and support: https://creakyjoints.org
- National Center for Complementary and Integrative Health - Research on natural approaches: https://www.nccih.nih.gov/health/arthritis