Arthritis Medication

There are different types of medicines for different types of arthritis. You may need to take a combination of these to treat your symptoms and the disease itself. Your consultant will decide which are best for you – and if you have problems with them, you can always talk to your rheumatology nurse.

There are a number of basic categories of medicines – each category works in a different way. These are explained below, along with an A-Z of arthritis medicines.

The source of the information on this page is Arthritis Research UK, used with kind permission.

Arthritis Treatments/Therapies

You may be prescribed painkillers such as paracetamol, codeine or co-codamol. They’ll help control the pain you’re in, but have to be taken regularly to maintain this effect.

Your GP can advise and prescribe them for you, so you will know how to take them safely to get the best effect. A pharmacist at your local chemist may also be a helpful person to talk to about your medicines.

Some painkillers may make you drowsy or a bit spaced-out. You may find that once another drug treatment takes effect, you don’t need painkillers as much.

Analgesic is another word for painkiller. Paracetamol is a common analgesic. It can be used to treat mild to moderate pain, and is sometimes used in addition to other medicines. You can buy some analgesics, like paracetamol, over the counter in pharmacies or supermarkets.
Stronger analgesics, such as compound analgesics (for example co-codamol and tramadol) and opioid analgesics, for treating more severe pain, are prescribed by a doctor.

Analgesics shouldn’t be taken in high doses or for long periods of time.

Read more about analgesics

Drugs in this group help to reduce pain, stiffness and swelling. There are loads of different NSAIDs but common ones include ibuprofen, naproxen and diclofenac. They have to be taken regularly to get the full effect.
If NSAIDS are to be taken for a length of time some people may benefit from also taking a proton pump inhibitor ( PPI), a drug which reduces stomach acid, to help protect the lining of the stomach. Examples of PPIs are Omeprazole  and Lansoprazole.

These act by altering the underlying disease rather than treating symptoms, which is really clever. They’re not painkillers, but they’ll reduce pain, swelling and stiffness over a period of weeks or months by slowing down the disease and its effects on the joints.

Conventional DMARDs are slow to act and can take several weeks to work, so you need to keep taking them even if they don’t seem to be doing anything at first.

The most common DMARD is methotrexate. You have to take this for a while before it kicks in – but it does reduce inflammation and reduces joint damage. Patients commonly take methotrexate for many years to help protect their joints over the long term.

These are newer drugs which have only been around for the last decade or so. They’re commonly used with patients who don’t respond to methotrexate or similar drugs. They may also be used in combination with conventional DMARDs.

Biological therapies slow down the progress of arthritis and also reduce pain, swelling and stiffness. Common biological therapies include etanercept and infliximab.

Some biological therapies are called anti-TNF drugs. They target a protein called tumour necrosis factor, which increases inflammation when excess amounts are present in the blood or joints. Other biological therapies target different proteins.

Young people with arthritis may benefit on occasion from steroid injections into the affected joint. Like other drug therapies, this reduces inflammation, pain and stiffness, but it is a short term solution to treat symptoms and doesn’t control the inflammatory process in the way that DMARDs or biologics do.

The injection can be done under general anaesthetic for young children, but as you get older you can have the injection with a local anaesthetic.

The injections can be effective for several months and have few side effects.

Steroid tablets are also sometimes prescribed. A doctor would always advise on how to take them, and if taken for a length of time you may have the dose gradually reduced rather than immediately stop, to ensure no negative reaction.

The need for surgery for arthritis is quite rare these days, particularly if you have been treated quickly.

Dr Moorthy Arumugam, consultant rheumatologist at the University Hospitals of Leicester NHS Trust, says: “Nowadays with modern targeted treatment, surgery is less often required.”

However, some people with arthritis may benefit from surgery. It is important to note that surgery is never rushed into, and is often only necessary as an absolute last resort for the few patients who don’t respond to other treatments, or experience complications.

Types of surgery that may be recommended are:

  • Synovectomy – This is done to remove inflamed joint tissue (synovium) that is causing unacceptable pain or is limiting your ability to function. The procedure may be done using arthroscopy (keyhole surgery).
  • Hip, knee, shoulder or elbow joint replacement – Damaged joint surfaces are replaced with artificial parts. For some this type of surgery may significantly relieve pain, increase mobility and improve function.
  • Foot, ankle, hand or wrist surgery – Occasionally patients may need this type of surgery, though it’s not usually necessary.

Your Rheumatologist or GP can refer you to an Orthopaedic Consultant for opinion and advice.

Find out more about surgery for arthritis at Arthritis Research UK

A-Z of Arthritis Medications

Abatacept

This drug is an infusion (given through a drip) used to treat rheumatoid arthritis. It’s a biological therapy which works by stopping the function of a particular cell in the immune system (called a T-cell). This prevents the inflammation and immune activity which cause the symptoms of rheumatoid arthritis. Find out more

Adalimumab (humera)

Adalimumab is used to treat rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, and children with juvenile idiopathic arthritis (JIA). It’s an anti-TNF (anti-tumour necrosis factor) drug, which reduces inflammation. Find out more

Amitriptyline

Amitriptyline is used to treat chronic pain – that’s pain which lasts for a long time – caused by arthritis, spinal problems, fibromyalgia, chronic headaches and peripheral neuropathy (damage to nerve endings in your upper and lower limbs). Depending on the dose prescribed, it can act as an analgesic (a fancy word for painkiller) or an anti-depressant. Find out more

Antiemetics

Antiemetics are tablets taken to reduce nausea. They can be helpful to reduce side-effects from certain medicines. Metoclopromide is one often prescribed.

Azathioprine

Azathioprine is used to treat rheumatoid arthritis. It’s one of those clever drugs called disease-modifying anti-rheumatic drugs (DMARDs). These drugs actually dampen down the underlying disease, rather than simply treating the symptoms. Find out more

Certolizumab pegol (cimzia)

This drug is an injection used to treat rheumatoid arthritis. It’s another anti-TNF (anti-tumour necrosis factor) drug which reduces inflammation. Find out more

Ciclosporin

Ciclosporin is used to treat rheumatoid arthritis, psoriatic arthritis and systemic lupus erythematosus (SLE). It’s a disease-modifying anti-rheumatic drug (DMARD) which targets the underlying disease. Find out more

Cyclophosphamide

Cyclophosphamide is used to treat several different types of rheumatic disease, including systemic lupus erythematosus (SLE), and diseases where there’s inflammation of blood vessels (vasculitis) or muscles (myositis). Occasionally it’s used for severe rheumatoid arthritis. It’s a powerful disease-modifying anti-rheumatic drug (DMARD). Find out more

Etanercept (enbrel)

Etanercept is an injection used to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and juvenile idiopathic arthritis (JIA). It’s a type of drug known as anti-TNF (anti-tumour necrosis factor), which reduces inflammation. Find out more

Gold injections

Gold injections are used to treat auto-immune conditions such as rheumatoid arthritis and psoriatic arthritis. The drug is made from a compound that contains gold, and it’s a type of disease-modifying anti-rheumatic drug (DMARD). Find out more

Golimumab (simponi)

Golimumab is an injection used to treat rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. It’s an anti-TNF (anti-tumour necrosis factor) drug, which reduces inflammation.Find out more

Hydroxychloroquine

Hydroxychloroquine is used to treat rheumatoid arthritis and lupus. It goes by the trade name Plaquenil and is a type of drug known as a disease-modifying anti-rheumatic drug (DMARD).Find out more

Infliximab

Infliximab is an infusion (drip) used to treat rheumatoid arthritis, psoriatic arthritis and occasionally severe ankylosing spondylitis. It’s an anti-TNF (anti-tumour necrosis factor) drug, which reduces inflammation. Find out more

Leflunomide

Leflunomide is used to treat rheumatoid arthritis and other auto-immune diseases. It’s a type of disease-modifying anti-rheumatic drug (DMARD) which targets the disease itself rather than just the symptoms. Find out more

Local steroid injections

Steroid injections are used to target inflamed joints that have been affected by different types of arthritis. They give short term relief of sypmtoms but don’t control the disease process. Find out more

Methotrexate

Methotrexate is used to treat auto-immune conditions such as rheumatoid arthritis, psoriatic arthritis and vasculitis. It’s a type of disease-modifying anti-rheumatic drug (DMARD) which targets the disease itself rather than just the symptoms. Methotrexate is most commonly given as a tablet or injection. Find out more

Mycophenolate

Mycophenolate is used to treat lupus and vasculitis. It’s often known by the trade name CellCept. It’s a type of drug known as a disease-modifying anti-rheumatic drug (DMARD). These drugs have the effect of dampening down the underlying disease process, rather than simply treating symptoms. Find out more

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) are used to treat many different types of arthritis. They reduce inflammation, which helps to ease joint pain and stiffness. Many commonly used NSAIDs like ibuprofen are available to buy over the counter, while stronger types are only available on prescription Find out more

Painkillers

Many different types of drugs can be used to help ease pain – such paracetamol. You can take them to ease pain or during flare-ups. Find out more

Rituximab

Rituximab is used to treat rheumatoid arthritis, lupus, vasculitis and dermatomyositis. It’s a type of drug called a biological therapy. Find out more

Steroids

Steroids can be given in tablet form, as an injection, or as an infusion (drip).  Steroids are used to treat JIA, rheumatoid arthritis, lupus and polymyalgia rheumatica (PMR). Prednisolone is the most commonly prescribed steroid tablet. Find out more

Sulfasalazine

Sulfasalazine is used to treat rheumatoid arthritis, psoriatic arthritis, reactive arthritis and arthritis associated with bowel inflammation. It’s a type of disease-modifying anti-rheumatic drug (DMARD) which targets the disease itself rather than just the symptoms. Find out more

Tocilizumab

Tocilizumab is an infusion (drip) used to treat rheumatoid arthritis. It’s a type of biological therapy which reduces inflammation. Find out more