By Dr. Paul Tuttle, Pediatric and Adult Rheumatologist
Those who suffer with rheumatoid arthritis (RA) know the discomfort, pain, and debilitation it can cause. This inflammatory disease affects the joints, and it gets worse over time unless the inflammation is managed, slowed or in best cases, stopped.
Anti-inflammatory medication, which prevents joint deterioration, is vital to controlling the progression of, and relieving the symptoms of, rheumatoid arthritis. That means this medication helps RA patients feel better and live more mobile, pain-free lives.
Taking medication for rheumatoid arthritis, or any condition, is not without risk, however. Watch any TV commercial for medication, and you hear the announcer rattle off a litany of possible side effects. Yes, medication that helps people who have rheumatoid arthritis can have side effects. But it is “can,” not “will” produce side effects — and that makes all the difference.
For Better or Worse: Talk about it.
When discussing medications, patients and doctors should talk about the potential risks in light of the benefits. We work closely with our patients to assure they have the absolute best care. That includes making sure they receive the most effective medication to help alleviate the inflammation and pain of arthritis with the least amount of side effects. We weigh the positives with any potential negatives and decide together what would be best for optimal health and wellness.
Rheumatoid arthritis medication falls into several categories, each with its pros and the possibility of some cons:
- Nonsteroidal anti-inflammatory medications (NSAIDs). These work by blocking pathways that promote inflammation. By reducing inflammation, NSAIDS help reduce swelling and pain.
- Disease-modifying antirheumatic drugs (DMARDs). These target the immune system to slow the progress of rheumatoid arthritis. They are not pain medications, but over time as joint tissue becomes less inflamed, pain will be reduced.
- Cortiocosteroids. These are hormones that are either produced by the body or are man-made. They offer strong anti-inflammatory effects in conditions that are related to immune system functions, such as rheumatoid arthritis.
- Biologic agents. Used with patients who suffer from moderate to severe RA and don’t respond to traditional disease-modifying antirheumatic drugs (DMARDs), biologics zero in on specific areas that control the inflammation process.
Different medications cause different side effects in different people. That makes it nearly impossible to create a comprehensive list of medications and there possible effects. However, there are some common side effects for the different categories of arthritis medications:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Swelling of feet, heartburn, upset stomach, and ulcers.
- Disease-modifying antirheumatic drugs (DMARDs). Upset stomach and increased susceptibility to infection.
- Cortiocosteroids. Increased appetite, cataracts, elevated blood sugar levels, bone loss, and increased susceptibility to infection.
- Biologic agents. Injection site reactions, infusion reactions like difficulty breathing, nausea or vomiting, and increased risk of serious infections.
The above list of potential side effects can be scary. But it doesn’t have to be. There is a lot patients can do to assure side effects pass them by:
- Let your doctor know about any other medications you are taking; over-the-counter (OTC) ones as well as nutritional supplements.
- Find out if there are certain foods you should eat or avoid while taking a medication. Some medication should be taken with food, some with no food.
- Pass on the cocktails. Consuming alcohol can add to the side effects of some drugs.
- Take the drug at the time designated. Take mediation at the optimum time and you may be able to reduce the dose and the risk of side effects.
- Never stop taking any medication without consulting your doctor. Your doctor prescribes the medication to help you, so of course, it needs to be taken in order to do so.
- Let your doctor know if you suspect a side effect. Communicating concerns is the best way to stay on top of your pain management, side effects, and your overall health.
Open and honest communication between physician and patient is the best way to assure the patient is receiving the correct medicine and dosages for the most effective rheumatoid arthritis treatment. At OSMS, we apply all our expertise to monitor our patient’s medications. But we also need our patients to talk to us about how they are feeling. Together, we establish a plan to getting them feeling the best they can.
Dr. Tuttle is a Pediatric and Adult Rheumatologist who sees patients at the OSMS Rheumatology and Infusion Therapy Clinic in Appleton