Rheumatoid Arthritis Drugs: What Works and How to Use Them
If you’ve been diagnosed with rheumatoid arthritis (RA), the first thing on your mind is likely how to stop the pain and joint damage. The good news? There are several drug families that can keep inflammation in check, protect joints, and improve quality of life.
Types of RA Drugs
NSAIDs (Non‑steroidal anti‑inflammatories) – Think ibuprofen or naproxen. They’re over‑the‑counter or prescription options that reduce swelling and ease pain. NSAIDs don’t stop the disease from progressing, but they give quick relief for flare‑ups.
DMARDs (Disease‑Modifying Antirheumatic Drugs) – These are the backbone of long‑term RA care. Methotrexate is the most common, taken once a week, and it slows joint damage. Other conventional DMARDs include sulfasalazine, hydroxychloroquine, and leflunomide.
Biologic DMARDs – Biologics target specific parts of the immune system. Popular choices are adalimumab (Humira), etanercept (Enbrel), and rituximab (Rituxan). They’re given by injection or infusion and work well when methotrexate alone isn’t enough.
Targeted synthetic DMARDs – Newer oral meds like tofacitinib (Xeljanz) block JAK enzymes that drive inflammation. They sit between traditional DMARDs and biologics in terms of potency and side‑effect profile.
Tips for Safe Use
Start low, go slow. Your doctor will usually begin with the lowest effective dose to see how you tolerate it. Always take methotrexate with food and a folic‑acid supplement; this cuts down on nausea and liver issues.
Watch labs regularly. Blood tests for liver function, kidney health, and blood counts are essential, especially with methotrexate or leflunomide. Biologics require checks for infections like TB before you start.
Stay on schedule. Missing a weekly dose of methotrexate can reduce its benefit, while skipping injections of a biologic may lead to flare‑ups.
Know the side effects. NSAIDs can irritate stomach lining, so consider a proton‑pump inhibitor if you have ulcers. DMARDs may cause fatigue or mild hair loss; serious issues are rare but need prompt medical attention.
Combine with lifestyle moves. Exercise, even gentle range‑of‑motion work, helps keep joints flexible. A balanced diet rich in omega‑3 fatty acids (like salmon or flaxseed) can also tone down inflammation.
If you’re pregnant or planning to become one, tell your doctor right away. Some DMARDs are safe in pregnancy (hydroxychloroquine), while others (methotrexate) are not and must be stopped months before conception.
Never stop a medication abruptly without talking to your rheumatologist. Sudden changes can trigger a rebound flare or cause withdrawal symptoms, especially with steroids like prednisone.
Ask about biosimilars. These are lower‑cost versions of biologic drugs that work the same way. They’re approved by regulators and can save you money.
Keep a symptom diary. Write down pain levels, stiffness duration, and any side effects. This record helps your doctor fine‑tune the treatment plan.
Remember, RA treatment is a partnership. Your feedback guides adjustments, and regular check‑ups keep the disease under control. With the right mix of medication and self‑care, many people live active lives despite rheumatoid arthritis.
- By Percival Harrington
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- 19 Apr 2025
5 Methotrexate Alternatives: Options When MTX Isn’t Right for You
Stuck on methotrexate but not seeing results or dealing with side effects? You’re not alone. This article breaks down five alternatives to methotrexate, covering how each works, their pros and cons, and what makes them different. You'll find practical info to help you sort out your next steps with your doctor. Whether you’re new to RA meds or considering a switch, there’s something here to help you make a confident decision.