Common Rheumatoid Arthritis Medications
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Rheumatoid Arthritis Medication List



Rheumatoid arthritis (RA) is the second most common type of arthritis, affecting about 1.5 million Americans. It’s an inflammatory disease that’s caused by an autoimmune condition. The disease occurs when your body attacks its own healthy joint tissues. This results in redness, inflammation, and pain.

The main goal of RA drugs is to block inflammation. This helps prevent joint damage. Read on to learn about the many treatment options for RA.

DMARDs and biologics

Disease-modifying antirheumatic drugs (DMARDs) are used to decrease inflammation. Unlike other medications that temporarily ease pain and inflammation, DMARDs can slow the progression of RA. This means that you may have fewer symptoms and less damage over time.

The most common DMARDs used to treat RA include:

Biologics are injectable drugs. They work by blocking specific inflammatory pathways made by immune cells. This reduces inflammation caused by RA. Doctors prescribe biologics when DMARDs alone aren’t enough to treat RA symptoms. Biologics aren’t recommended for people with compromised immune systems or an infection. This is because they can raise your risk of serious infections.

The most common biologics include:

Janus associated kinase inhibitors

Your doctor may prescribe these drugs if DMARDs or biologics don’t work for you. These medications affect genes and the activity of immune cells in the body. They help prevent inflammation and stop damage to joints and tissues.

Janus associated kinase inhibitors include:

Baricitinib is a new drug that’s being tested. Studies suggest that it works for people who don’t have success with DMARDs.

The more common side effects of these drugs include:

  • headache
  • upper respiratory infections, like sinus infections or the common cold
  • congested nose
  • runny nose
  • sore throat
  • diarrhea


Acetaminophen is available over the counter (OTC) without a prescription from your doctor. It comes as an oral drug and a rectal suppository. Other drugs are much more effective at reducing inflammation and treating pain in RA. This is because acetaminophen can treat mild to moderate pain, but it doesn’t have any anti-inflammatory activity. This means it doesn’t work very well to treat RA.

This drug carries the risk of serious liver problems, including liver failure. You should only take one drug that contains acetaminophen at a time.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are among the most commonly used RA drugs. Unlike other pain relievers, NSAIDs seem to be more effective in treating symptoms of RA. This is because they prevent inflammation.

Some people use OTC NSAIDs. However, stronger NSAIDs are available with a prescription.

Side effects of NSAIDs include:

  • stomach irritation
  • ulcers
  • erosion or burning a hole through your stomach or intestines
  • stomach bleeding
  • kidney damage

In rare cases, these side effects can be fatal (cause death). If you use NSAIDs for a long time, your doctor will monitor your kidney function. This is especially likely if you already have kidney disease.

People who are allergic to aspirin should not take NSAIDs.

Ibuprofen (Advil, Motrin IB, Nuprin)

OTC ibuprofen is the most common NSAID. Unless instructed by your doctor, you should not use ibuprofen for more than several days at a time. Taking this drug for too long can cause stomach bleeding. This risk is greater in seniors.

Ibuprofen is available in prescription strengths as well. In prescription versions, the dosage is higher. Ibuprofen may also be combined with another type of pain drug called opioids. Examples of these prescription combination drugs include:

Naproxen sodium (Aleve)

Naproxen sodium is an OTC NSAID. It’s often used as an alternative to ibuprofen. This is because it causes slightly fewer side effects. Prescription versions of this drug offer stronger dosages.

Aspirin (Bayer, Bufferin, St. Joseph)

Aspirin is an oral pain reliever. It’s used to treat mild pain, fever, and inflammation. It can also be used to prevent heart attack and stroke.

Prescription NSAIDs

When OTC NSAIDs don’t relieve your RA symptoms, your doctor may prescribe a prescription NSAID. These are oral drugs. The most common options include:

Other NSAIDs include:

Diclofenac/misoprostol (Arthrotec)

Diclofenac/misoprostol (Arthrotec) is an oral drug that combines the NSAID diclofenac with misoprostol. NSAIDs can cause stomach ulcers. This drug helps prevent them.

Topical capsaicin (Capsin, Zostrix, Dolorac)

Capsaicin topical OTC cream can relieve mild pain caused by RA. You rub this cream on painful areas on your body.

Diclofenac sodium topical gel (Voltaren 1%)

Voltaren gel 1% is an NSAID for topical use. This means you rub it on your skin. It’s approved to treat joint pain, including in your hands and knees.

This drug causes similar side effects to oral NSAIDs. However, only about 4 percent of this drug is absorbed into your body. This means that you may be less likely to have side effects.

Diclofenac sodium topical solution (Pennsaid 2%)

Diclofenac sodium (Pennsaid 2%) is a topical solution used for knee pain. You rub it on your knee to relieve the pain.

Opioid pain drugs

Opioids are the strongest pain drugs on the market. They’re only available as prescriptions drugs. They come in oral and injectable forms. Opioids are only used in RA treatment for people with severe RA who are in intense pain. These drugs can be habit-forming. If your doctor gives you an opioid drug, they’ll watch you closely.

Read more: New guidelines to prevent opioid addiction »

People with RA who take opioids should also use other treatments. This is because opioids only change the way you experience pain. They don’t slow the disease down or prevent inflammation.

Opioids include:


Corticosteroids are also called steroids. They come as oral and injectable drugs. These drugs can help reduce inflammation in RA. They may also help reduce the pain and damage caused by inflammation. These drugs aren’t recommended for long-term use.

Side effects can include:

  • high blood sugar
  • stomach ulcers
  • high blood pressure
  • emotional side effects, such as irritability and excitability
  • cataracts, or clouding of the lens in your eye
  • osteoporosis

Steroids used for RA include:


These drugs fight off the damage caused by autoimmune diseases such as RA. However, these drugs can also make you more prone to illness and infection. If your doctor gives you one of these drugs, they’ll watch you closely during treatment.

These drugs come in oral and injectable forms. They include:

Alternative options
Omega-3 fatty acids may offer some benefit in reducing inflammation in your body. You can get omega-3s through your diet. For example, fish like sardines, halibut, and anchovies are high in omega-3s. Other foods like walnuts, canola oil, and ground flaxseed also contain smaller amounts of omega-3s. You can also take omega-3 supplements.

Learn more: Natural remedies for RA flare-ups »


Work with your doctor to find the RA treatment that works best for you. With so many options available, you and your doctor are likely to find one that eases your RA symptoms and improves your quality of life.

Read Video Transcript »

Rheumatoid arthritis is an autoimmune inflammatory arthritis. The word "auto" means self, so these are diseases in which the immune system attacks itself. Normally your immune system is not supposed to do that. It's supposed to attack viruses, bacteria, fight off infections, but in some people for whatever reason their immune system gets confused and attacks its own tissues. In the case of rheumatoid arthritis the immune system makes inflammation, the inflammation runs through the body and settles into certain areas, especially into the joints, and if it settles into those joints it can cause pain, swelling, stiffness, and over time that swelling has chemicals, which can cause destruction of bone underneath it, leading to deformity and disability.

Once a diagnosis of rheumatoid arthritis is made, depending on the severity we decide on the treatment path. Traditionally we use two groups of medications, the disease modifying medications referred to as DMARDS, and the biologic medications. Traditionally we start with a DMARD if the symptoms are relatively mild. If on the other hand the symptoms are more severe, we may start with a biologic medication. Oftentimes we find ourselves combining various combinations of these medications to get adequate control of the disease.

Disease modifying medications or DMARDS have been on the market for many years. They're oral medications that act on the immune system in a more general way. They act on overactive immune processes, whereas biologic medications, this newer group of medications, is much more specific targeted therapy.

One of the most important properties of our immune system is to make inflammation. Say for example you get a cut or a wound. It's your immune system that detects the danger and makes inflammation. Inflammation is made by a group of proteins referred to as cytokines. These are signaling proteins.They tell cells to make inflammation.

Some of the newer treatments referred to as biologic medications target specific pro-inflammatory cytokines. By preventing or inhibiting these inflammatory cytokines, inflammation is prevented from being made.

The majority of our patients actually are on various combinations of medications and to adequately control our patients oftentimes we combine these medications. Occasionally we get lucky. We find a patient that may be in the early stages or has very mild disease or has a great response to just an oral disease modifying medication. This happens in about a third of our patients, however two-thirds of our patients require various combinations of disease modifying medications or disease modifying medications plus a biologic.

Oftentimes we will often cycle through various biologics. If one biologic doesn't work, we may swap it out for another one to achieve better control of the disease.

If a patient has persistent joint pain, stiffness, or swelling, then they are most likely failing their current therapy. On the other hand, at times patients feel that their symptoms are adequately controlled, however there are certain objective measures that the rheumatologist monitors, and if those objective measures such as blood work, ultrasound, x-rays are showing persistent disease activity, then also we consider that the patient is failing current therapy. In either situation we try to dose adjust these patients or change medications to get better control of their disease process.