Medications for Osteoarthritis
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The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your healthcare provider if you need to take any special precautions. Use each of these medications as recommended by your healthcare provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your healthcare provider.
There are a variety of medications available to treat the pain and inflammation of osteoarthritis. You may have to try different medicines before you find the one that works best for you, with the least number of side effects.
Prescription Medications
Nonsteroidal Anti-inflammatory drugs (NSAIDs)
- Naproxen (Naprosyn, Anaprox, Aleve)
- Ketoprofen (Orudis)
- Ibuprofen (Motrin, Advil, Nuprin)
- Indomethacin (Indocin)
- Sulindac (Clinoril)
- Meclofenamate (Meclomen)
- Ketorolac (Toradol)
- Piroxicam (Feldene)
- Diclofenac sodium (Voltaren)
- Diclofenac (Voltaren, Cataflam)
Cyclooxgenase-2 or COX-2 Inhibitors
- Celecoxib (Celebrex)
- Meloxicam (Mobic)
Prescription Medications
Nonsteroidal Anti-inflammatory Agents (NSAIDs)
- Naproxen (Naprosyn, Anaprox, Aleve)
- Ketoprofen (Orudis)
- Ibuprofen (Motrin, Advil, Nuprin)
- Indomethacin (Indocin)
- Sulindac (Clinoril)
- Meclofenamate (Meclomen)
- Ketorolac (Toradol)
- Piroxicam (Feldene)
- Diclofenac sodium (Voltaren, Cataflam)
Although many NSAIDs are available as over-the-counter medications, you may be given a prescription for a higher dose. Nonsteroidal anti-inflammatory agents help decrease inflammation, swelling, and joint pain.
Always take NSAIDs with food to decrease the chance of stomach irritation.
Drinking alcoholic beverages or taking other NSAIDs while you’re already using an NSAID can increase your risk of side effects.
Possible side effects include:
- Stomach upset
- Stomach ulcers
- Kidney damage
- Liver inflammation
- Confusion, dizziness, lightheadedness
- Severe allergic reaction (hives, difficulty breathing, swelling around the eyes)
- Increased risk of bleeding – Always inform your healthcare providers that you’re taking a NSAID before having any medical or dental procedures or surgeries.
A study looked at topical vs. oral ibuprofen to relieve chronic knee pain. Comparing the two groups, there were no significant differences in pain, stiffness, or difficulty. Those in the oral group, however, experienced more side effects.
Cyclooxygenase-2 or COX-2 Inhibitors
COX-2 inhibitors work in a way similar to NSAIDs, helping to decrease inflammation, swelling, and joint pain. In addition, they have the benefit of causing less stomach irritation. In particular, COX-2 inhibitors cause far fewer stomach ulcers than do NSAIDs.
Drinking alcoholic beverages or taking NSAIDs while you’re using a COX-2 inhibitor can increase your risk of side effects.
Possible side effects include:
- Liver inflammation
- Confusion
- Severe allergic reaction ( hives , difficulty breathing, swelling around the eyes)
- Stomach upset
- Heart attack
- Stroke
Over-the-Counter Medications
Acetaminophen
Common brand names include:
- Tylenol
Acetaminophen can be helpful in relieving some of the pain associated with osteoarthritis. Do not take a larger dose than is recommended by your healthcare provider. Do not drink alcoholic beverages if you are taking acetaminophen on a daily basis.
Side effects are rare. A few people may experience an allergic reaction after taking the drug. If you develop a rash, swelling, or difficulty breathing, stop taking the acetaminophen and get medical attention.
Acetaminophen should be considered the first-line drug treatment in most osteoarthritis patients. In a study, 80% of patients were unable to distinguish between the effects of sustained-relief acetaminophen and celcoxib for overall symptom improvement.
Capsaicin Cream
Common brand names include:
Capsaicin cream is a rubbed on the skin of an affected joint to relieve the pain and inflammation of osteoarthritis.
Capsaicin cream is made from the active ingredient of hot chile peppers. Some people prefer to wear rubber gloves while applying the cream. If you don’t, be sure to wash your hands thoroughly with soap and water after using the cream. Be very careful not to get the cream near your eyes, as it will burn and sting. If you do get some in your eyes, flush them thoroughly with cool water.
Possible side effects include:
- Burning, stinging, or warm sensation when first applied to the skin.
Special Considerations
Whenever you are taking a prescription medication, take the following precautions:
- Take your medication as directed. Do not change the amount or the schedule.
- Do not stop taking them without talking to your doctor.
- Do not share them.
- Know what the results and side effects. Report them to your doctor.
- Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
- Plan ahead for refills so you don’t run out.
References:
Arthritis Foundation website. Available at: http://www.arthritis.org/ .
Conn’s Current Therapy . 54th ed. W.B. Saunders Company; 2002.
Drug Facts and Comparisons . 56th ed. Facts & Comparisons; 2001.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .
Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. American Family Physician . 2000;51(6). Available at: http://www.aafp.org/afp/20000315/1795.html.
3/17/2007 DynaMed's Systematic Literature Surveillance : Yelland MJ, Nickles CJ, McNairn N, Del Mar CB, Schluter PJ, Brown RM. Celecoxib compared with sustained-release paracetamol for osteoarthritis: a series of n-of-1 trials. Rheumatology (Oxford). 2007;46:135-140. Epub 2006 Jun.
2/7/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Underwood M, Ashby D, Cross P, et al. Advice to use topical or oral ibuprofen for chronic knee pain in older people: randomised controlled trial and patient preference study. BMJ. 2008;336:138-142. Epub 2007 Dec 4.
Last reviewed September 2009 by Jill D. Landis, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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