Even though there is no actual treatment for rheumatoid arthritis (RA) to this day, there are a number of available medications in pharmacies that are designed to manage its symptoms and eventually improve the patient's condition.

In general, RA medications can be classified into different classes, as enumerated in the succeeding paragraphs. Doctors can make proper plan for treatment to reduce joint inflammation and pain, and stop further damage to the joints. Depending on each case, successful treatment can be attained through a combination of the following options:

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Nonsteroidal Anti-inflammatory Drugs, abbreviated as NSAIDs, work in relieving pain and reducing inflammation, but do not function to prevent further joint. Nonsteroidal Anti-inflammatory Drugs stop the human body from manufacturing a substance called prostaglandins, which which sets off pain & inflammation.

Some examples of NSAIDs are naproxen (Aleve and Naprosyn) and ibuprofen (Advil and Motrin). Other NSAID examples include etodolac (Lodine), meloxicam (Mobic), ketoprofen (Orudis), Celecoxib (Celebrex), indomethacin, oxaprozin (Daypro), diclofenac (Voltaren, Cataflam), piroxicam (Feldene), and nabumetone (Relafen).

These drugs are commonly advised as soon as a positive RA diagnosis is made. But remember that when consumed in extreme dosages for extended periods, these medications can cause severe side effects, including gastric ulcers, stomach bleeding, plus liver and kidney damage.

Corticosteroids

Another group of medication used for RA treatment is corticosteroids. Such medications block the immune system, thus alleviating inflammation.

Methylprednisolone (SoluMedrol, DepoMedrol), Cortisone (Cortone), betamethasone (Celestone Soluspan), dexamethasone (Decadron), prednisolone (Delta-Cortef), triamcinolone (Aristocort), plus prednisone (Deltasone and Orasone), are some of the most common corticosteroids.

Although corticosteroids may be successful in treating RA, they have been reported to cause negative side effects if taken in prolonged periods. Examples of such side effects include cataracts, easy bruising, glaucoma, thinning bones, diabetes, and excessive weight gain.

Due to the potential for severe side effects, such medications are often only used as a momentary solution to curtail sudden RA outbreaks. On the plus side, just one injection of corticosteroids will block inflammation of a specific joint lasting for a long time.

Disease Modifying Anti-Rheumatic Drugs, a.k.a. DMARDs

DMARDs are a group of drugs that serve to inhibit your immune system from causing damage to the joints, gradually hindering further joint damage progression. When treating rheumatoid arthritis, disease modifying anti-rheumatic drugs are commonly taken alongside other meds for more successful results.

Rheumatoid arthritis causes permanent damage to the joints, which appears in the early stages. Accordingly, most doctors would advise DMARD therapy soon after making a diagnosis. Patients are most responsive to DMARD treatment in the early stages of RA. The earlier DMARDs are taken, the more advantageous it is for the person.

Some DMARD examples are methotrexate (Rheumatrex), hydroxychloroquine (Plaquenil), cyclosporine (Sandimmune, Neoral), gold salts (Solganal, Aurolate, Myochrysine, Ridaura), cyclophosphamide, penicillamine (Cuprimine), azathioprine (Imuran), minocycline, leflunomide (Arava), and sulfasalazine (Azulfidine).

Though a number of DMARD products have been effective in rheumatoid arthritis treatment, the risks for negative side effects is enormous. Taking DMARDs for a long time may lead to toxicity of the bone marrow and liver, vulnerability to infections, skin allergies, and even autoimmunity.

Of the DMARD examples mentioned above, hydroxychloroquine has the lowest risk of producing liver & bone marrow toxicity, and is consequently considered as 1 of the safest DMARDs. The bad news is that hydroxychloroquine isn't a particularly powerful drug and is not strong enough on its own to curtail RA symptoms.

Conversely, methotrexate is considered to be one of the most powerful DMARDs to use in treating rheumatoid arthritis because of several reasons. It has been known to treat RA without causing bone marrow and liver toxicity like the majority of DMARDs. Further, it works effectively and safely when used in combination with biological agents, another type of RA drugs to be discussed later. It is for this reason that methotrexate is frequently prescribed together with biological agents if the drug fails to control the condition on its own. Then again, keep in mind that while methotrexate is not as risky as other DMARDs, it still canobstruct the bone marrow or cause hepatitis. In these cases, regular blood tests are advised to manage the patient's condition, as well as to stop treatment at the first sign of complications.

Biological Agents

Biological agents or biological drugs function to treat inflammation via a range of methods.

One example of how biological drugs work is by inhibiting tumor necrosis factors (TNFs). Infliximab (Remicade), adalimumab (Humira), and etanercept (Enbrel) are some TNF blockers.

Another method of how biological agents curtail inflammation is through killing B cells. Rituximab (Rituxan), for example, merges itself to B cells, ultimately destroying them.

Further medications that reduce inflammation through their own way are:

- tocilizumab (Actemra and RoActemra), functions by blocking interleukin 6 or IL-6 - anakinra (Kineret), blocks IL-1 (interleukin 1) - abatacept (Orencia), which serves to block T-cells

You must consider that every biological drug has its own potential for negative side effects. The risks for side effects must be considered when prescribing it to a patient.

Salicylates

Salicylates reduce prostaglandins production. Prostaglandins generate the pain and inflammation of arthritis. In recent years, the use of salicylates have been generally replaced with nonsteroidal anti-inflammatory drugs (NSAIDs), mainly since salicylates can cause negative side effects, such as damaging the kidney.

Pain Relief Medications

Lastly, various pain relief drugs can likewise be taken in rheumatoid arthritis treatment. Examples of pain relief medications are acetaminophen (Tylenol) and tramadol (Ultram).

Although anti-pain drugs neither decrease inflammation nor prevent the progression of further joint damage, such medications allow the patient to feel more comfortable and eventually function better in his/her daily life. For this reason, anti-pain drugs are certainly worth considering.

Surgery as a Last Resort

If all the medications discussed previously fail to produce results, a physician may probably recommend surgical treatment. Some surgical procedures used in RA treatment are tendon repair, joint lining removal (i.e. synovectomy), as well as arthroplasty (joint replacement surgery), wherein the damaged parts of the joint are replaced with prosthetics.