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Understanding Rheumatoid Arthritis Medications (cont.)

Corticosteroids

Drugs in this class include betamethasone (Celestone Soluspan), cortisone (Cortone), dexamethasone (Decadron), methylprednisolone (SoluMedrol, DepoMedrol), prednisolone (Delta-Cortef), prednisone (Deltasone, Orasone), and triamcinolone (Aristocort).

How corticosteroids work: These drugs decrease swelling and inflammation by suppressing immune response.

Who should not use these medications: People with the following conditions should not use corticosteroids:

  • Allergy to corticosteroids
  • Active infections caused by viruses, fungi, or Mycobacterium tuberculosis
  • Active peptic ulcer disease
  • Liver impairment

Use: Corticosteroids can be taken in various ways (oral, injection, intravenous, intramuscular, intra-articular). The goal is to use the smallest dose that will control symptoms. The length of treatment should be as short as possible in order to decrease the risk of developing side effects. When taken orally, take with food to decrease stomach upset.

Drug or food interactions: Many drug interactions are possible; therefore, consult with a doctor or pharmacist before taking new prescription or over-the-counter medications. Aspirin, NSAIDs, such as Advil or Aleve, or other drugs associated with stomach ulcers may increase the risk of developing stomach ulcers. Corticosteroids may decrease potassium levels and must be used with caution with other drugs that decrease potassium levels (for example, diuretics (Lasix]).

Side effects: Ideally, corticosteroids are used for only a short time in order to bring sudden flares in symptoms under control. Long-term use is associated with serious side effects, such as osteoporosis, glaucoma, cataracts, mental changes, abnormal blood glucose, or arrested bone growth in children before puberty. After prolonged use, the corticosteroid dose must be gradually decreased over weeks to months to avoid corticosteroid withdrawal syndrome.

Investigational drugs

Many studies are evaluating drugs to improve symptoms and to halt or reverse joint destruction of rheumatoid arthritis. Contact a rheumatology specialist for information on new drugs that may be available soon.

REFERENCE:

Klippel, J.H., et al. Primer on the Rheumatic Diseases. New York: Springer, 2008.


Medically Reviewed by a Doctor on 8/13/2014

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