Medicines and products for rheumatoid arthritis

Medicines are the main treatment for rheumatoid arthritis. The goal is to control inflammation early, ease symptoms and prevent joint damage, aiming for remission or low disease activity. A rheumatologist decides the plan, and regular blood tests monitor safety.

Disease-modifying anti-rheumatic drugs (DMARDs)

• Conventional DMARDs: methotrexate is usually the first choice. Others include leflunomide, sulfasalazine and hydroxychloroquine, sometimes used in combination. They take weeks to months to work, so do not stop them early.
• Targeted synthetic DMARDs: JAK inhibitors such as tofacitinib and baricitinib, used when others are not enough, with attention to infection and clot risk.
• Biologic DMARDs: medicines such as adalimumab, etanercept, infliximab, tocilizumab and rituximab target specific immune signals. They need screening for TB and hepatitis before use.

Symptom relief

• NSAIDs, such as naproxen or ibuprofen, ease pain and stiffness but do not slow damage. They can affect the stomach, kidneys and heart.
• Corticosteroids (prednisolone) work quickly and are used in short courses or low doses. Long use causes weight gain, bone thinning and high sugar, so they are reduced as soon as possible.

Safety and monitoring Regular tests for blood counts, liver and kidney function. Report fever, persistent cough, mouth ulcers or unusual bruising promptly. Vaccinations should be updated, and live vaccines avoided on some drugs.

Pregnancy Methotrexate and leflunomide must be stopped well before pregnancy. Plan with your doctor.

Ayurvedic view (interpretive) Herbal and Ayurvedic products are sometimes used alongside medicines, but must be disclosed to your doctor, since some interact with DMARDs.

Remember Never stop or change a dose without medical advice, as flares and joint damage can follow.