Rheumatoid Arthritis (RA) Medications
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
- Rheumatoid arthritis overview
- Rheumatoid arthritis medications list
- What are the new classes of rheumatoid arthritis medications?
- What are effective over-the-counter medications for rheumatoid arthritis?
- What are effective natural medications for rheumatoid arthritis?
- What are the potential risks and benefits of injectable medications for rheumatoid arthritis?
- What are the best rheumatoid arthritis medications for pain?
- What are the side effects of rheumatoid arthritis medications?
- Rheumatoid arthritis medications special considerations: weight gain and pregnancy
- What are rheumatoid arthritis medications in development?
- What are the treatment options if rheumatoid arthritis medications are not working?
Rheumatoid arthritis overview
Rheumatoid arthritis (RA) is a disease in which the body's immune system attacks its own joints. This results in pain, swelling and potentially permanent damage. About 1.5 million people in the United States have RA and it affects women far more than men. RA should not be confused with osteoarthritis (OA) which is joint pain resulting from wearing down of cartilage – most commonly in the knees and hips. By contrast, RA commonly affects smaller joints, such as in the fingers and toes.
Rheumatoid arthritis medications list
Analgesics, or painkillers, are a staple of RA treatment. Mild-to-moderate RA pain can usually be treated with non-opioid analgesics. But for severe pain, opioids and opioid combinations are more effective. That increased effectiveness does come with the potential for side effects, including drowsiness and constipation.
Combination Products: Opioids plus Other Analgesics
- Acetaminophen with codeine (Tylenol #3, Tylenol #4)
- Acetaminophen with hydrocodone (Hycet, Lortab, Norco, Vicodin, Vicodin ES, Vicodin HP, Xodol, Zamicet)
- Aspirin with dihydrocodeine and caffeine (Synalgos-DC)
- Ibuprofen with hydrocodone (Ibudone, Reprexain, Vicoprofen)
- Acetaminophen with oxycodone (Percocet, Roxicet, Xartemis XR)
- Aspirin with oxycodone (Percodan)
Opoids (single ingredients)
- Fentanyl (Abstral, Actiq, Duragesic, Fentora, Lazanda, Onsolis, Subsys)
- Hydrocodone bitartrate (Hyslinga ER, Zohydro ER)
- Hydromorphone (Dilaudid, Dilaudid HP, Exalgo)
- Meperidine (Demerol)
- Methadone (Dolophine)
- Morphine sulfate (MS Contin, Kadian, Avinza)
- Oxycodone (Oxycontin, Oxecta)
- Oxymorphone (Opana, Opana ER)
- Tapentadol (Nucynta, Nucynta ER)
- Buprenorphine (Butrans, Buprenex)
- Butorphanol (Butorphanol NS, Stadol)
- Pentazocine (Talwin)
This class of drugs is also known as non-steroidal anti-inflammatory drugs (NSAIDs). They work by inhibiting and/or interfering with chemicals in the body which cause inflammation. The most common drawback to NSAID use is their propensity to cause stomach and gastrointestinal bleeding.
- Celecoxib (Celebrex)
- Diclofenac/Misoprostol (Arthrotect)
- Ibuprofen (Motrin, Advil)
- Indomethacin (Indocin)
- Naproxen (Naprosyn, Anaprox, Aleve)
- Naproxen/Esomeprazole (Vimovo)
- Naproxen/Lansoprazole (Prevacid NapraPAC)
- Oxaprozin (Daypro)
- Piroxicam (Feldene)
Biological drugs are proteins manufactured using recombinant DNA technology. They are immunosuppressants that target and block the action of cells or chemicals that enable the immune system to cause inflammation and other symptoms of RA. Biological agents are called disease-modifying antirheumatic drugs (DMARDs) because by suppressing components of the immune system they reduce symptoms and reverse the course of RA.
- Abatacept (Orencia)
- Adalimumab (Humira)
- Anakinra (Kineret)
- Certolizumab (Cimzia)
- Etanercept (Enbrel)
- Golimumab (Simponi)
- Infliximab (Remicade)
- Rituximab (Rituxan)
- Tocilizumab (Actemra)
Janus Kinase (JAKs) Inhibitor
JAK inhibitors are the newest class of drugs used to treat RA. They work by blocking Janus kinase JAKs) enzymes located within stem cells and other cells. JAKs enzymes are involved in stimulating immune responses that contribute to symptoms of RA. Therefore, inhibiting JAKs enzymes reduces symptoms of RA.
Tofacitinib (Xeljanz) is an oral drug and is the first JAKs inhibitor approved by the FDA.
Corticosteroids are synthetic versions of anti-inflammatory chemicals normally produced in the body. They are powerful, but long-term use can result in severe side effects, including weaker bones and a depressed immune system.
- Hydrocortisone (Cortef)
- Ethamethasoneb (Celestone)
- Fludrocortisone (Florinef)
- Methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol)
- Prednisolone (Prelone)
- Triamcinolone (Aristospan, Kenalog)
Disease-Modifying Antirheumatic Drugs (DMARDs)
DMARDs don't just relieve pain and/or inflammation of RA, they actually can alter the course of the chronic disease, and help stop some of the damage from getting worse. DMARDs include the biological drugs listed above as well as non-biological drugs listed below.
- Methotrexate, a cancer drug, is one of the most popular and effective drugs in this class.
- Azathioprine (Imuran)
- Auranofin (Ridaura)
- Chloroquine (Aralen)
- Cyclophosphamide (Cytoxan)
- Cyclosporine (Gengraf, Sandimmune)
- Gold sodium thiomalate (Myochrysine, Solganal)
- Hydroxychloroquine (Plaquenil)
- Leflunomide (Arava)
- Methotrexate (Rheumatrex)
- Minocycline (Minocin)
- Mycophenolate (CellCept)
- Penicillamine (Cuprimine)
- Sulfasalazine (Azulfidine)
Get the latest treatment options