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Sjogren Syndrome (cont.)

Medications

Systemic treatment

Drugs that increase saliva secretion: These can be used if topical therapy is insufficient in dry mouth. Examples include pilocarpine (Salagen) and cevimeline (Evoxac). The most common adverse effect is increased sweating (in as many as 29%).

Nonsteroidal anti-inflammatory drugs (NSAIDs): These agents reduce inflammation and mild to moderately severe pain. Examples are ibuprofen, naproxen, and celecoxib (Celebrex). These agents should be used with caution if you have aspirin sensitivity or kidney disease. If you are older than 65 years, have ever had peptic ulcer disease, use steroids or blood thinners, smoke cigarettes, or drink alcohol, talk to your health care provider about alternatives.

Disease-modifying antirheumatic drugs: These drugs treat rheumatoid arthritis and other rheumatic conditions that do not get better with NSAIDs. Examples include hydroxychloroquine (Plaquenil), penicillamine (Cuprimine), azathioprine (Imuran), methotrexate (Rheumatrex), and gold salts (Auranofin). Newer biological agents are being studied for the treatment of Sjögren syndrome.

Immunosuppressive drugs: These agents may be suitable for people with Sjögren syndrome who develop a major organ manifestation such as interstitial lung disease. Examples include prednisone (cortisone), cyclophosphamide (Cytoxan), and azathioprine (Imuran). These medications have a number of different side effects that should be discussed carefully with your health care provider. If you take one of these medications, you may have to have blood tests regularly.