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This page is for your information only. Much of what you learn here is what many  doctors will not willingly share with you, especially when it comes to the dangerous side effects of the drugs. It is important to remember that you cannot in any way drug yourself into being cured. 

   Doctors will tell you that they don't really know what causes arthritis and speculate heredity or some other possible reason. The only thing they do know for sure is that there is no cure for arthritis.  

    I know that arthritis is reversible, I have been through it all;  severe swelling and pain, with tests, drugs and treatments.  I was given no hope for improvement, (unless you call drugs, joint replacements and wheelchairs improvements). I didn't think so.

   In the beginning I blindly went along with the drugging and tests, holding on to the false hope that I would be cured of this terrible disease. It didn't take very long to find out that the word "cured" was not associated with this disease in the medical world.

    Something inside me led me on my search to discover the truth about arthritis and it's many types. Through years of research I learned how it is caused and how to reverse it.

  You have a choice, a new choice, one that was never offered to you before. The choice is not deciding what drug or treatment you want to follow to cope with arthritis as it progressively gets worse. The real choice now is whether you want to live with or live without arthritis, free of pain and the harmful effects of the drugs.  As you read below ask yourself, "is this the route I want to take?" If your answer is "NO" then let the truth speak for itself.  I will show you when you discover   Arthritis Revealed .   Download Book

Arthritis Drugs

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Arthritis Treatments

     Doctor recommended arthritis remedies follow a pyramid structure with fewer treatment possibilities available as the disease progresses.

     For someone searching for an arthritis remedy doctors may initially prescribe some form of pain killer or analgesic therapy. In the short term these therapies may make the pain bearable but long term use is not advised due to side effects. Analgesics represent a short term remedy and only address the arthritis symptoms and do nothing to reverse the disease.

Experimental

2nd level

Treatments

1st level

     The first level of arthritis therapies are called Non Steroidal Anti-Inflammatory Drugs; NSAID. This class of drugs actually reduce the formation of one of the agents responsible for pain and inflammation, postaglandins. As an arthritis therapy, NSAID are not 100% effective and have not demonstrated the ability to slow the progress of the disease. Because of the side effects associated with NSAID usage the patient and doctor should monitor their use closely.

   Corticosteriod treatments ( Steriod Treatments ) are also used for Rheumatiod Arthritis sufferers to combat short term flare ups. Again, due to the serious nature of the long term side effects doctors tend to be cautious in there use.

     If the success of the previous therapy is left wanting, doctors will move to second level of therapies. These are called Disease Modifying Anti-Rheumatic Drugs or DMARD and are often used to combat Rheumatiod Arthritis. DMARD are used to reduce the inflammation in joints and can be effective in preventing damage to them. These therapies can take several months to have an effect but must be watched closely due to the possibility of serious side effects.

          If these therapies fail the doctor and patient may decide to embark on a third level approach, Experimental treatments.

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Arthritis Drugs

Arthritis drugs are classified into two main catagories known as NSAID and DMARD.

Both drug catagories have Serious Side Effects !

     As mentioned above arthritis drugs are prescribed by doctors using a two level approach with an experimental third level when all else fails. The first level includes arthritis drugs known as NSAID or Non-Steroidal Anti-Inflammatory Drugs. The second level of arthritis drugs, known as DMARD, or Disease Modifying Anti-Rheumatic Drugs which are introduced as the disease progresses; possibly in combination with NSAID.

     If the arthritis drug treatment does not give the desired results, then the doctor and patient may agree to use experimental treatments. 

As yet there is no medical cure for Arthritis.  

   There are various arthritis drug treatment regimens available to ease the pain and perhaps even slow the progression of the disease. Unfortunately these drugs can have dangerous effects and the arthritis will continue to get worse.

     It is frustrating for the patients to change from one arthritis drug to another searching for the medicine that works for them.  But, even more frustrating to Arthritis sufferers is that all of these arthritis drugs exhibit some or all of the following serious side effects.

   Below is a list of some of the common NSAID - Non-Steroidal Anti-Inflamatory Drugs.

Click on any one of the drugs below to view the side effects of each:

   In most cases, these arthritis drugs simply mask Arthritis pain while the patient continues to deteriorate as the disease progresses.  What's more, the effectiveness of these arthritis drugs decreases with time requiring higher dosage and/or combinations of other arthritis drugs to receive the same pain relief.

Celebrex - The new kid on the block.

     The next step in Arthritis drug treatment is DMARD.  These arthritis drugs actually address some of the causes of Arthritis pain, inflammation and swelling.  The idea behind DMARD arthritis drugs is to prevent further damage to the joints. In some cases, some level of remission is achieved.  Unfortunately, this is not as common as one would hope.

     Below is a list of some of the common DMARD - Disease Modifying Anti-Rheumatic Drugs.

Arthritis Drugs

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Arthritis Pain

Arthritis pain is a cruel example of what the Worlds #1 Chronic Health Disease can do !

     Arthritis pain sufferers number over 40 million people in the United States. Arthritis pain debilitates, deforms and disfigures people of all ages.  Most arthritis pain sufferers are affected by one of two major forms of arthritis; Osteo Arthritis and Rheumatoid Arthritis.  Over 100 types of Arthritis have been identified.

     "Patients with rheumatoid arthritis have increased mortality compared with the general population". Pincus T, Callahan LF. Taking mortality in rheumatoid arthritis seriously--predictive markers, socioeconomic status and comorbidity. J Rheumatol. 1986;13:841-5.

     "A significant decline in functional status over time has also been seen with this disease". Wolfe F, Hawley DJ, Cathey MA. Clinical and health status measures over time: prognosis and outcome assessment in rheumatoid arthritis. J Rheumatol. 1991;18:1290-7.

     "Patients with rheumatoid arthritis have an increase in work disability; 50% are work disabled within 10 years of disease onset". Mitchell JM, Burkhauser RV, Pincus T. The importance of age, education, and comorbidity in the substantial earnings losses of individuals with symmetric polyarthritis. Arthritis Rheum. 1988;31:348-57.

     "Disability from rheumatoid arthritis and other types of symmetric polyarthritis costs more than 6.5 billion dollars per year (in 1986 U.S. dollars) in lost earnings". Mitchell JM, Burkhauser RV, Pincus T. The importance of age, education, and comorbidity in the substantial earnings losses of individuals with symmetric polyarthritis. Arthritis Rheum. 1988;31:348-57.

     "A threefold increase in medical costs for patients with this disease compared with an age- and sex-matched population was reported in 1989". Felts W, Yelin E. The economic impact of the rheumatic diseases in the United States. J Rheumatol. 1989;16:867-84.

    There are costs for this disease that affects millions of people in the United States for which no definite cure exists. In our current, controlled, and perhaps restricted health care environment, the implications of the cost (both direct and indirect) are clearly evident and of great concern.

     The treatment of arthritis has has taken a new approach over the past several years .  Arthritis specialist in this field now advocate earlier treatment or therapy with a group of heterogeneous drugs termed either "DMARDs" (disease-modifying antirheumatic drugs), "SAARDs" (slow-acting antirheumatic drugs), or "second-line therapies." These drugs include hydroxychloroquine, sulfasalazine, methotrexate, gold salts, d-penicillamine, azathioprine, and cyclosporine.

     The old method of treatment was called the "pyramid approach." At the base of the pyramid anti-inflammatory drugs were used, such as aspirin and nonsteroidal anti-inflammatory drugs, which were prescribed along with a simple program of exercise, rest, and education.

   Second-line therapy was initiated only after several years of treatment with anti-inflammatory drugs and generally after radiographic evidence of joint damage. In fact, many rheumatologists waited for such evidence, considering it to be the reason to start second-line therapy.

   Part of the justification for delaying the initiation of second-line therapy was the perceptions that rheumatoid arthritis was a benign disease and that second-line therapies were very toxic. Over the past decade, we have come to realize that rheumatoid arthritis is not benign,

 Wilske KR, Healey LA. Remodeling the pyramid--a concept whose time has come. J Rheumatol. 1989;16:565-7.
 Kushner I, Dawson NV. Changing perspectives in the treatment of rheumatoid arthritis [Editorial]. J Rheumatol. 1992;19:1831-4.
 Pincus T, Callahan LF. Remodeling the pyramid or remodeling the paradigms concerning rheumatoid arthritis-lessons from Hodgkin's disease and coronary artery disease [Editorial]. J Rheumatol. 1990;17:1582-5.
 McCarty DJ. Suppress rheumatoid inflammation and leave the pyramid to the Egyptians [Editorial]. J Rheumatol. 1990;17:1115-8.

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SALICYLATES family of medicines, (Systemic)

Arthropan  Anacin  Ascriptin  Aspirin  Bufferin  Bayer  

Ecotrin      Magan      Magnaprin      Trilisate      Zorprin

Side Effects of These Medicines

Above are some of the more common salicylate drugs taken for arthritis.

Get emergency help immediately if any of the following side effects occur:

   Any loss of hearing; bloody urine; confusion; convulsions (seizures); diarrhea (severe or continuing); difficulty in swallowing; dizziness, lightheadedness, or feeling faint (severe); drowsiness (severe); excitement or nervousness (severe); fast or deep breathing; flushing, redness, or other change in skin color; hallucinations (seeing, hearing, or feeling things that are not there); increased sweating; increased thirst; nausea or vomiting (severe or continuing); shortness of breath, troubled breathing, tightness in chest, or wheezing; stomach pain (severe or continuing); swelling of eyelids, face, or lips; unexplained fever; uncontrollable flapping movements of the hands (especially in elderly persons); vision problems

   Also, check with your doctor as soon as possible if any of the following side effects occur:

More common:

   Abdominal or stomach cramps, pain, or discomfort (mild to moderate); heartburn or indigestion; nausea or vomiting

Less common:

   Abdominal or stomach pain, cramping, or burning (severe); bloody or black, tarry stools; headache (severe or continuing); ringing or buzzing in ears (continuing); skin rash, hives, or itching; unusual tiredness or weakness; vomiting of blood or material that looks like coffee grounds.

   Trouble in sleeping, nervousness, or jitters (This can be caused by some products that contain caffeine)

   Other side effects not listed above may also occur in some persons.

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ANTI-INFLAMMATORY DRUGS, NONSTEROIDAL, (Systemic)

Advil     Anaprox     Ansaid     Butazolidin     Clinoril  

 Dolobid     Excedrin     Feldene     Ibuprofen     Indocin

Lodine     Meclomen     Medipren     Motrin     Nalfon

Naprosyn     Naproxen     Nuprin     Orudis     Oruvail

Relafen     Rufen     Surgam     Tolectin     Tolmetin

Side Effects of These Medicines

Above are some of the more common nonsteroidal drugs taken for arthritis.

   Stop taking this medicine and get emergency help right away if any of the following side effects occur:

More common:

   Bleeding from rectum (with suppositories); headache (severe), especially in the morning (for indomethacin only); skin rash,  Abdominal or stomach cramps, pain, or discomfort (mild to moderate); diarrhea (if taking mefenamic acid, stop taking it and check with your doctor immediately); dizziness, drowsiness, or lightheadedness; headache (mild to moderate); heartburn, indigestion, nausea, or vomiting

Rare:

   Fainting; fast or irregular breathing; fast, irregular heartbeat or pulse; hive-like swellings (large) on face, eyelids, mouth, lips, or tongue; puffiness or swelling of the eyelids or around the eyes; shortness of breath, troubled breathing, wheezing, or tightness in chest, abdominal or stomach pain, cramping, or burning (severe); bloody or black, tarry stools; chest pain; convulsions (seizures); fever with or without chills; nausea, heartburn, and/or indigestion (severe and continuing); pinpoint red spots on skin; sores, ulcers, or white spots on lips or in mouth; spitting up blood; unexplained nosebleeds; unusual bleeding or bruising; vomiting of blood or material that looks like coffee grounds

Also, check with your doctor as soon as possible if any of the following side effects occur:

Less common :

   Bitter taste or other taste change; bloated feeling, gas, or constipation; decreased appetite or loss of appetite; fast or pounding heartbeat; flushing or hot flashes; general feeling of discomfort or illness; increased sensitivity of eyes to light; increased sensitivity of skin to sunlight; increased sweating; irritation, dryness, or soreness of mouth; nervousness, anxiety, irritability, trembling, or twitching; rectal irritation (with suppositories); trouble in sleeping; unexplained weight loss; unusual tiredness or weakness without any other symptoms.

      All anti-inflammatory analgesics are very similar, it is possible that any of the above side effects may occur with any of these medicines.

   Other side effects not listed above may also occur in some persons. If you notice any other effects, check with your doctor.

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DICLOFENAC AND MISOPROSTOL, (Systemic)

                      (Brand Name) Arthrotec

Side Effects of This Medicine

   Check with your doctor as soon as possible if any of the following side effects occur:

 More common:

   Diarrhea; gas; heartbur

 Less common:

   Black, tarry stools; bleeding or crusting sores on lips; blood in urine or stools; bruises and/or red spots on the skin; chest pain; chills; confusion; continuing thirst; convulsions (seizures); cough or hoarseness; disorientation; drowsiness; fainting; fever with or without chills; fluid retention; general feeling of illness; heartburn and/or indigestion; increased blood pressure; increased heart rate; increased weight gain; itching of the skin; irregular heartbeat; large, flat, blue or purplish patches on the skin; light-headedness or dizziness; lower back or side pain; mental depression; muscle cramps; nausea; painful or difficult urination; pounding heartbeat; psychotic reaction; rectal bleeding; seeing, hearing, or feeling things that are not there; severe headache; severe hepatic reactions; severe stomach pain, cramping or burning; shortness of breath, troubled breathing, tightness in chest, and/or wheezing; skin rash; sores, ulcers, or white spots on lips or in mouth; sore throat; stiff neck and/or back; sudden decrease in the amount of urine; swelling and/or tenderness in upper stomach; swelling of face, fingers, feet, and/or lower legs; unusual bleeding or bruising; unusual tiredness or weakness; vomiting of material that looks like coffee grounds; yellow eyes or skin, abnormal vision; acne; change in sense of taste; decreased appetite; dry mouth; irritability or nervousness; loss of hair; muscle pain; decrease in sexual ability; tingling, burning, or prickling sensations; trembling or shaking; trouble swallowing; vaginal bleeding

Rare:

   Changes in facial skin color; fast or irregular breathing; puffiness or swelling of the eyelids or around the eyes

         Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor. 

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ANTI-INFLAMMATORY DRUGS, NONSTEROIDAL (Ophthalmic)

Indomethacin       Indocid

Side Effects of These Medicines

   Check with your doctor as soon as possible if any of the following side effects occur:

More common:

   Burning, stinging, or mild discomfort after application; dry eyes

Less common:

   Bleeding in the eye or redness or swelling of the eye or the eyelid (not present before you started using this medicine or becoming worse while you are using this medicine); blurred vision or other change in vision; fever or chills; itching or tearing; nausea or vomiting; pain; sensitivity to light; shortness of breath; sticky or matted eyelashes; swelling of face; throbbing pain; tightness in chest; troubled breathing; wheezing

   Other side effects may occur that usually do not need medical attention. The following side effects usually do not need medical attention. However, check with your doctor if they continue or are bothersome.

Less common:

   Bigger or smaller pupils (black part of eye); headache; trouble in sleeping; runny or stuffy nose; unusual weakness

   Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

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SULFASALAZINE (Systemic)

Azulfidine / Salazopyrin

Side Effects of These Medicines

   Check with your doctor immediately if any of the following side effects occur:

More common:

   Aching of joints; headache (continuing); itching; skin rash, Increased sensitivity of skin to sunlight

 Check with your doctor if any of the following side effects continue or are bothersome:

More common:

   Abdominal or stomach pain or upset; diarrhea; loss of appetite; nausea or vomiting

Less common:

   Aching of joints and muscles; back, leg, or stomach pains; bloody diarrhea; bluish fingernails, lips, or skin; chest pain; cough; difficult breathing; difficulty in swallowing; fever, chills, or sore throat; general feeling of discomfort or illness; loss of appetite; pale skin; redness, blistering, peeling, or loosening of skin; unusual bleeding or bruising; unusual tiredness or weakness; yellow eyes or skin

   In some patients this medicine may also cause the urine or skin to become orange-yellow. This side effect does not need medical attention.

   Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

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Cuprimine

Side Effects of This Medicine

   Check with your doctor as soon as possible if any of the following side effects occur:

More common:

Fever; joint pain; lesions on the face, neck, scalp, and/or trunk; skin rash, hives, or itching; swollen and/or painful glands; ulcers, sores, or white spots on lips or in mouth

Less common:

Bloody or cloudy urine; shortness of breath, troubled breathing, tightness in chest, or wheezing; sore throat and fever with or without chills; swelling of face, feet, or lower legs; unusual bleeding or bruising; unusual tiredness or weakness; weight gain

Rare:

Abdominal or stomach pain (severe); blisters on skin; bloody or black, tarry stools; chest pain; coughing or hoarseness; dark urine; difficulty in breathing, chewing, talking, or swallowing; eye pain, blurred or double vision, or any change in vision; general feeling of discomfort or illness or weakness; lower back or side pain; muscle weakness; painful or difficult urination; pale stools; pinpoint red spots on skin; redness, tenderness, itching, burning, or peeling of skin; red or irritated eyes; red, thick, or scaly skin; ringing or buzzing in the ears; spitting blood; yellow eyes or skin

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common:

Diarrhea; lessening or loss of sense of taste; loss of appetite; nausea or vomiting; stomach pain (mild)

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

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CYCLOPHOSPHAMIDE (Systemic)

Cytoxan

Side Effects of This Medicine

   Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These may include certain types of cancer, such as leukemia or bladder cancer. Discuss these possible effects with your doctor.

   Check with your doctor or nurse immediately if any of the following side effects occur:

More common:

   Cough or hoarseness; fever or chills; lower back or side pain; missing menstrual periods; painful or difficult urination, Darkening of skin and fingernails; loss of appetite; nausea or vomiting

   With high doses and/or long-term treatment:

   Blood in urine; dizziness, confusion, or agitation; fast heartbeat; joint pain; shortness of breath; swelling of feet or lower legs; unusual tiredness or weakness

Less common:

   Black, tarry stools or blood in stools; pinpoint red spots on skin; unusual bleeding or bruising, Diarrhea or stomach pain; flushing or redness of face; headache; increased sweating; skin rash, hives, or itching; swollen lips

Rare:

   Frequent urination; redness, swelling, or pain at site of injection; sores in mouth and on lips; sudden shortness of breath; unusual thirst; yellow eyes or ski

    Cyclophosphamide may cause a temporary loss of hair in some people. After treatment has ended, normal hair growth should return, although the new hair may be a slightly different color or texture.

   After you stop using cyclophosphamide, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effect:

   Blood in urine

   Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Arthritis Treatments

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AZATHIOPRINE (Systemic)

Imuran

Side Effects of This Medicine

   Also, because of the way this medicine acts on the body, there is a chance that it might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia, lymphoma, or skin cancer. However, the risk of cancer seems to be lower in people taking azathioprine for arthritis. Discuss these possible effects with your doctor.

  Check with your doctor as soon as possible if any of the following side effects occur:

More common

   Cough or hoarseness; fever or chills; lower back or side pain; painful or difficult urination; unusual tiredness or weakness, Loss of appetite; nausea or vomiting.

Less common

   Black, tarry stools; blood in urine or stools; pinpoint red spots on skin; unusual bleeding or bruising, Skin rash, Liver problems

Rare

   Fast heartbeat; fever (sudden); muscle or joint pain; nausea, vomiting, and diarrhea (severe); redness or blisters on skin; shortness of breath; sores in mouth and on lips; stomach pain; swelling of feet or lower legs; unusual feeling of discomfort or illness (sudden)

For patients taking this medicine for rheumatoid arthritis :

   Signs and symptoms of blood problems (black, tarry stools; blood in urine or stools; cough or hoarseness; fever or chills; lower back or side pain; painful or difficult urination; pinpoint red spots on skin; unusual tiredness or weakness; or unusual bleeding or bruising) are less likely to occur in patients taking azathioprine for rheumatoid arthritis than in patients taking azathioprine for transplant rejection. This is because lower doses are often used.

   After you stop using this medicine, it may still produce some side effects that need attention. During this period of time check with your doctor as soon as possible if you notice any of the following:

   Black, tarry stools; blood in urine; cough or hoarseness; fever or chills; lower back or side pain; painful or difficult urination; pinpoint red spots on skin; unusual bleeding or bruising

   Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

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CHLORAMBUCIL (Systemic) = Generic name

Leukeran  =  Brand name

Side Effects of This Medicine

   Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor

   Check with your doctor or nurse immediately if any of the following side effects occur:

Less common:

   Black, tarry stools; blood in urine or stools; cough or hoarseness, accompanied by fever or chills; fever or chills; lower back or side pain, accompanied by fever or chills; painful or difficult urination, accompanied by fever or chills; pinpoint red spots on skin; sores in mouth and on lips; unusual bleeding or bruising, Joint pain; lower back or side pain; skin rash; swelling of feet or lower legs, Changes in menstrual period; itching of skin; nausea and vomiting.

Rare:

   Cough; blisters on skin; shortness of breath; skin rash (severe), Agitation; confusion; convulsions (seizures); hallucinations (seeing, hearing, or feeling things that are not there); muscle twitching; tremors; trouble in walking; weakness (severe) or paralysis; yellow eyes or skin

After you stop using chlorambucil, it may still produce some side effects that need attention. During this period of time, check with your doctor if you notice any of the following side effects:

Black, tarry stools; blood in urine or stools; cough or hoarseness (may be accompanied by fever or chills); fever or chills; lower back or side pain, accompanied by fever or chills; painful or difficult urination, accompanied by fever or chills; pinpoint red spots on skin; shortness of breath; unusual bleeding or bruising

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Arthritis Treatments

Arthritis Drugs

Arthritis Pain

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GOLD COMPOUNDS (Systemic)

Myochrysine / Ridaura / Solganal

Side Effects of This Medicine

   Gold compounds have been shown to cause tumors and cancer of the kidney when given to animals in large amounts for a long time. However, these effects have not been reported in humans receiving gold compounds for arthritis. If you have any questions about this, check with your doctor.

   Side effects may occur at any time during treatment with this medicine and up to many months after treatment has ended , and they may need medical attention.

   Check with your doctor as soon as possible if any of the following side effects occur:

More common:

   Irritation or soreness of tongue—less common with auranofin; metallic taste—less common with auranofin; skin rash or itching; redness, soreness, swelling, or bleeding of gums—rare with auranofin; ulcers, sores, or white spots on lips or in mouth or throat

Less common:

   Bloody or cloudy urine; hives

Rare

   Abdominal or stomach pain, cramping, or burning (severe); bloody or black, tarry stools; confusion; convulsions (seizures); coughing, hoarseness, difficulty in breathing, shortness of breath, tightness in chest, or wheezing; dark urine; decreased urination; decreased vision; difficulty in swallowing; feeling of something in the eye; fever; hair loss; hallucinations (hearing, seeing, or feeling things that are not there); irritation of nose, throat, or upper chest area, possibly with hoarseness or coughing; irritation of vagina; nausea, vomiting, or heartburn (severe and/or continuing); numbness, tingling, pain, or weakness, especially in the face, hands, arms, or feet; pale stools; painful or difficult urination; pain in lower back, side, or lower abdomen (stomach) area; pain, redness, itching, or tearing of eyes; pinpoint red spots on skin; problems with muscle coordination; red, thickened, or scaly skin; sore throat and fever with or without chills; swelling of face, fingers, ankles, lower legs, or feet; swellings (large) on face, eyelids, mouth, lips, and/or tongue; swollen and/or painful glands; unusual bleeding or bruising; unusual tiredness or weakness; vomiting of blood or material that looks like coffee grounds; yellow eyes or skin

   Check with your doctor if the following side effects continue or are bothersome:

More common with auranofin; rare with injections

   Abdominal or stomach cramps or pain (mild or moderate); bloated feeling, gas, or indigestion (mild or moderate); decrease or loss of appetite; diarrhea or loose stools; nausea or vomiting (mild or moderate)

Less common

   Constipation—with auranofin; joint pain—with injections

   Some patients receiving auranofin have noticed changes in the taste of certain foods. If you notice a metallic taste while receiving any gold compound, check with your doctor as soon as possible. If you notice any other taste changes while you are taking auranofin, it is not necessary to check with your doctor unless you find this effect especially bothersome.

   Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

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CYCLOSPORINE (Systemic)

Neoral / Sandimmune

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Some side effects will have signs or symptoms that you can see or feel. Your doctor will watch for others by doing certain tests.

Also, because of the way that cyclosporine acts on the body, there is a chance that it may cause effects that may not occur until years after the medicine is used. These delayed effects may include certain types of cancer, such as lymphomas or skin cancers. You and your doctor should discuss the good this medicine will do as well as the risks of using it.

Check with your doctor or nurse immediately if any of the following side effects occur:

Rare:

Blood in urine; flushing of face and neck (for injection only); wheezing or shortness of breath (for injection only)

Check with your doctor as soon as possible if any of the following side effects occur:

More common:

Bleeding, tender, or enlarged gums

Less common:

Convulsions (seizures); fever or chills; frequent urge to urinate; vomiting

Rare:

Confusion; general feeling of discomfort and illness; irregular heartbeat; numbness or tingling in hands, feet, or lips; shortness of breath or difficult breathing; stomach pain (severe) with nausea and vomiting; unexplained nervousness; unusual tiredness or weakness; weakness or heaviness of legs; weight loss

This medicine may also cause the following side effects that your doctor will watch for:

More common:

High blood pressure; kidney problems

Less common:

Liver problems; changes in blood chemistry

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common:

Increase in hair growth; trembling and shaking of hands

Less common:

Acne or oily skin; headache; leg cramps; nausea

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

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HYDROXYCHLOROQUINE (Systemic)

Plaquenil

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. When this medicine is used for short periods of time, side effects usually are rare. However, when it is used for a long time and/or in high doses, side effects are more likely to occur and may be serious.

Check with your doctor immediately if any of the following side effects occur:

Less common:

Blurred vision or any other change in vision—this side effect may also occur or get worse after you stop taking this medicine

Rare:

Convulsions (seizures); increased muscle weakness; mood or other mental changes; ringing or buzzing in ears or any loss of hearing; sore throat and fever; unusual bleeding or bruising; unusual tiredness; weakness

Symptoms of overdose:

Drowsiness; headache; increased excitability

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common:

Diarrhea; difficulty in seeing to read; headache; itching (more common in black patients); loss of appetite; nausea or vomiting; stomach cramps or pain

Less common:

Bleaching of hair or increased hair loss; blue-black discoloration of skin, fingernails, or inside of mouth; dizziness or lightheadedness; nervousness or restlessness; skin rash

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor. 

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CORTICOSTEROIDS Glucocorticoid Effects (Systemic)

Prednisolone

Side Effects of This Medicine

Corticosteroids may lower your resistance to infections. Also, any infection you get may be harder to treat. Always check with your doctor as soon as possible if you notice any signs of a possible infection, such as sore throat, fever, sneezing, or coughing.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. When this medicine is used for short periods of time, side effects usually are rare. However, check with your doctor as soon as possible if any of the following side effects occur:

Less common:

Decreased or blurred vision; frequent urination; increased thirst

Rare:

Blindness (sudden, when injected in the head or neck area); burning, numbness, pain, or tingling at or near place of injection; confusion; excitement; false sense of well-being; hallucinations (seeing, hearing, or feeling things that are not there); mental depression; mistaken feelings of self-importance or being mistreated; mood swings (sudden and wide); redness, swelling, or other sign of allergy or infection at place of injection; restlessness; skin rash or hives

Additional side effects may occur if you take this medicine for a long time. Check with your doctor if any of the following side effects occur:

Abdominal or stomach pain or burning (continuing); acne; bloody or black, tarry stools; changes in vision; eye pain; filling or rounding out of the face; headache; irregular heartbeat; menstrual problems; muscle cramps or pain; muscle weakness; nausea; pain in arms, back, hips, legs, ribs, or shoulders; pitting, scarring, or depression of skin at place of injection; reddish purple lines on arms, face, groin, legs, or trunk; redness of eyes; sensitivity of eyes to light; stunting of growth (in children); swelling of feet or lower legs; tearing of eyes; thin, shiny skin; trouble in sleeping; unusual bruising; unusual increase in hair growth; unusual tiredness or weakness; vomiting; weight gain (rapid); wounds that will not heal

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common:

Increased appetite; indigestion; loss of appetite (for triamcinolone only); nervousness or restlessness

Less common:

Darkening or lightening of skin color; dizziness or lightheadedness; flushing of face or cheeks; hiccups; increased joint pain (after injection into a joint); increased sweating; nosebleeds (after injection into the nose); sensation of spinning

After you stop using this medicine, your body may need time to adjust . The length of time this takes depends on the amount of medicine you were using and how long you used it. If you have taken large doses of this medicine for a long time, your body may need one year to adjust. During this time, check with your doctor immediately if any of the following side effects occur :

Abdominal, stomach, or back pain; dizziness; fainting; fever; loss of appetite (continuing); muscle or joint pain; nausea; reappearance of disease symptoms; shortness of breath; unexplained headaches (frequent or continuing); unusual tiredness or weakness; vomiting; weight loss (rapid)

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

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METHOTREXATE For Noncancerous Conditions (Systemic)

Methotrexate / Rheumatrex

Side Effects of These Medicine

   Along with their needed effects, medicines like methotrexate can sometimes cause unwanted effects such as blood problems, kidney problems, stomach or liver problems, loss of hair, and other side effects. These and others are described below. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

   Check with your doctor immediately if any of the following side effects occur:

Less common:

   Diarrhea; reddening of skin; sores in mouth and on lips; stomach pain, Acne; boils; loss of appetite; nausea or vomiting; pale skin; skin rash or itching.

Rare:

   Black, tarry stools; blood in urine or stools; blurred vision; chest pain; convulsions (seizures); cough or hoarseness; dead or loose skin layers; fever or chills; lower back or side pain; painful or difficult urination; painful peeling of skin patches; pinpoint red spots on skin; red blisters, ulcers on the lip, mouth, eye, nasal passages, and genital area; reddening of the skin with or without hair loss; shortness of breath; sloughing of skin , muscle and bone; unusual bleeding or bruising, Back pain; dark urine; dizziness; drowsiness; headache; unusual tiredness or weakness; yellow eyes or skin. 

   This medicine may cause a temporary loss of hair in some people. After treatment with methotrexate has ended, normal hair growth should return.

   Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Additional Information

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, methotrexate is used in certain patients with the following medical conditions:

• Psoriatic arthritis

• Systemic dermatomyositis

• Seronegative arthritides

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.

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Celebrex, the new kid on the block

What is Celebrex used for?

Celebrex is used to:

• relieve the signs and symptoms of osteoarthritis and rheumatoid arthritis in adults.

• reduce the number of colorectal polyps in patients with Familial Adenomatous Polyposis (FAP). FAP is an inherited disorder in which the rectum and colon are covered with many polyps. Celebrex should be used along with the usual care for FAP patients such as surgery and monitoring of the lower gastrointestinal tract.

• Celebrex has not been shown to reduce colorectal, duodenal or other FAP-related cancers. It is not known whether the effects of Celebrex will last after treatment is stopped. The efficacy and safety of Celebrex treatment in FAP patients beyond six months has not been studied. Therefore, the usual care of FAP patients should not be altered because of the concurrent administration of Celebrex. In particular, the frequency of routine endoscopic surveillance should not be decreased and prophylactic colectomy or other FAP-related surgeries should not be delayed.

• Acute pain in adults

• Painful menstrual cycles

Who should not take Celebrex?

You should not take Celebrex if you:

• have had an allergic-type reaction to sulfa drugs

• have had asthma, hives or allergic-type reactions after taking aspirin or other NSAIDs (nonsteroidal anti-inflammatory drugs). A few examples of NSAIDs are ibuprofen, naproxen, diclofenac, nabumetone, and ketoprofen.

Special Warnings with Celebrex:

Serious problems from stomach ulcers such as bleeding are recognized complications in people treated with NSAID’s. Similar problems have occurred in people treated with Celebrex. The likelihood of stomach problems increases the longer you take drugs like Celebrex. However, even short-term treatment is not without risk. These problems can happen without any warning, but in some people may cause symptoms such as gnawing or burning stomach pain, black or tarry stools, or vomiting. If this happens, stop taking Celebrex and call your health care provider right away.

Check with your health care provider. Celebrex may not be right for you, if you:

• have had ulcers or stomach bleeding

• have had asthma, hives or allergic-type reactions after taking aspirin or other NSAIDs

• have severe kidney problems

• have severe liver problems

• are pregnant

General Precautions with Celebrex:

Do not stop taking any medications that you have been prescribed without first talking to you doctor.

Serious problems such as liver damage have occurred in people treated with NSAIDs. Some of the warning signs of liver damage can be nausea, vomiting, fatigue, loss of appetite, itching, yellow coloring of skin or eyes, "flu-like" symptoms and dark urine. If this happens call your health care provider right away.

Celebrex can cause fluid retention and swelling in some patients. Check with your health care provider to see if Celebrex is right for you, if you:

• retain fluids

• have high blood pressure

• have heart failure

If you have asthma, you may have aspirin-sensitive asthma. If an aspirin-sensitive asthmatic takes aspirin it can cause severe narrowing of the airway (bronchospasm), and even death. Since such reactions to aspirin and other NSAIDs have occurred in aspirin-sensitive patients, Celebrex should not be given to aspirin-sensitive patients.

The safety and effectiveness of Celebrex in patients below the age of 18 years has not been determined.

Avoid taking Celebrex with antacids that contain calcium carbonate and magnesium/aluminum combination products, because they may reduce the amount of Celebrex your body absorbs.

What should I tell my doctor or health care provider?

• Tell your health care provider if you are trying to become pregnant, are already pregnant, or are breast-feeding.

• Because certain medications may interact with NSAIDs or Celebrex, review all medications that you take with your health care provider, including those that you take without a prescription.

• Your health care provider may have to adjust your dose or monitor you more closely if you take:

  • certain blood pressure medications called ACE-inhibitors

  • furosemide

  • fluconazole

  • lithium

  • warfarin

  • aspirin

What are some possible side effects of Celebrex? (This is NOT a complete list of side effects reported with Celebrex. Your health care provider can discuss with you a more complete list of side effects.)  

Side effects can include:

• Headache

• Indigestion

• Upper respiratory tract infection

• Diarrhea

• Sinus inflammation

• Stomach pain

• Nausea                                                

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