"You have to take the good with the bad."

Whoever coined that phrase originally could have been referring to arthritis medications. While medications can make physical movement easier and less painful, they can also do some things you'd rather they didn't. Upset stomach, dry mouth, drowsiness, and increased risk of infection are some of the more benign of these side effects, but there are others that are decidedly worse.

Some side effects will disappear on their own as your body adjusts to the drug. For others, you can alleviate side effects by taking medications with food, supplementing nutrients the drug can affect, or using other medications to ease the first drug's effects (e.g. acetaminophen to ease injection pain, an artificial saliva product to ease dry mouth, or an antacid to ease stomach upset). For still others, you may have to learn to live with the side effects, especially if the benefits of taking the drug outweigh the consequences.

Sometimes, the bad exceeds the good and side effects can signal something life-threatening. Here are some side effects of the most commonly used arthritis medications that require immediate attention:

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
Rapid or irregular pulse, hives on the face or mouth, wheezing, or tightness in the chest may indicate an allergic reaction to the drug. Stop taking the NSAID and get medical attention immediately.

Symptoms such as dark, tarry stools, or vomiting blood or material that looks like coffee grounds could mean a bleeding ulcer. Unusual bleeding or bruising could mean the drugs are interfering with clotting. If you have one of these problems, call your doctor right away.

DMARDs (Disease Modifying Anti-Rheumatic Drugs)
DMARDs control arthritis by suppressing the immune system. Because this can also make it more difficult to fight infection, it's important that you call your doctor right away if you have symptoms of infection, including a fever, cough, hoarseness or sore throat. You should also consult with your doctor before getting any vaccinations while you are taking these drugs.

Corticosteroids
Though corticosteroids are potent anti-imflammatories, they also have the potential to do great harm. They have been shown to cause brittle bones, cataracts and elevated blood sugar, particularly if they are taken in high doses or for long periods of time. If you start to notice symptoms of diabetes (e.g. increased thirst, frequent urination and/or blurred vision), or neurological problems (e.g. hallucinations or rapid and wide mood swings), call your doctor as soon as possible.

These are some of the most common drugs used to combat the pain of arthritis, but there are many others used for all forms of arthritis and its related conditions. Any drug, for any condition, carries the risk of side effects. Before beginning any medication, read the drug's package insert. Ask your doctor if there are side effects you should watch for and what to do if you experience them. And, pay attention to what your body is telling you. If you're taking a medication, even one you've taken for a while, and you notice a problem, call your doctor.

As another familiar saying cautions us, "It's better to be safe than sorry."

Bruce C. Bailey, Ph.D.