Guide To Osteoarthritis

Doctors prescribe medications to eliminate or reduce pain and to improve functioning. Doctors consider a number of factors when choosing medicines for their patients with osteoarthritis. Two important factors are:

the intensity of the pain

the potential side effects of the medication

Patients must use medicines carefully and tell their doctors about any changes that occur.

The following types of medications are commonly used in treating osteoarthritis:

Acetaminophen

Acetaminophen (Tylenol, Excedrin) is a pain reliever that does not reduce swelling. Acetaminophen does not irritate the stomach and is less likely than non-steroidal anti-inflammatory drugs (NSAIDs) to cause long-term side effects. Research has shown that acetaminophen relieves pain as effectively as NSAIDs for many patients with osteoarthritis.

Warning: People with liver disease, people who drink alcohol heavily, and those taking blood-thinning medicines or NSAIDs should use acetaminophen with caution.

NSAIDs (non-steroidal anti-inflammatory drugs)

Many NSAIDs are used to treat osteoarthritis. All NSAIDs work similarly: they fight inflammation and relieve pain. However, each NSAID is a different chemical, and each has a slightly different effect on the body. Many are available as over-the-counter drugs for example:

• Aspirin (Bayer, Excedrin)
• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve, Naprosyn)
• Ketoprofen (Orudis, Oruvail)

Other prescription NSAIDs include:

• Ansaid (Flurbiprofen)
• Arthrotec (Diclofenac/Misoprostol)
• Cataflam (Diclofenac Potassium)
• Clinoril (Sulindac)
• Daypro (Oxaprozin)
• Dolobid (Diflunisal)
• Feldene (Piroxicam)
• Indocin (Indomethacin)
• Lodine (Etodolac)
• Meclomen (Meclofenamate)
• Mobic (Meloxicam)
• Nalfon (Fenoprofen)
• Ponstel (Mefanamic Acid)
• Relafen (Nabumetone)
• Tolectin (Tolmetin)
• Voltaren (Dicolfenac Sodium)

Side effects

NSAIDs can cause stomach irritation or, less often, they can affect kidney function.

The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious.

Many other drugs cannot be taken when a patient is being treated with NSAIDs because NSAIDs alter the way the body uses or eliminates these other drugs. (Check with your health care provider or pharmacist)

NSAIDs sometimes are associated with serious gastrointestinal problems, including ulcers, bleeding, and perforation of the stomach or intestine.

People over age 65 and those with any history of ulcers or gastrointestinal bleeding should use NSAIDs with caution.

COX-2 inhibitors

COX-2 inhibitors such as Celecoxib (Celebrex), are also used to treat osteoarthritis. These medicines reduce inflammation similarly to traditional NSAIDs, but they cause fewer gastrointestinal side effects. However, these medications occasionally are associated with harmful reactions ranging from mild to severe.

Other medications

Doctors may prescribe several other medicines for osteoarthritis, including the following:

Topical pain-relieving creams, rubs, and sprays (for example, capsaicin cream), which are applied directly to the skin.

Mild narcotic painkillers, which--although very effective--may be addictive and are not commonly used.

Viscosupplementation (Hyaluronic acid) a medicine for joint injection is used to treat osteoarthritis of the knee. This substance is a normal component of the joint, involved in joint lubrication and nutrition.

Corticosteroids, powerful anti-inflammatory hormones made naturally in the body or manmade for use as medicine.

Steroids may be injected into the affected joints to temporarily relieve pain. This is a short-term measure, generally not recommended for more than two or three treatments per year. Oral corticosteroids should not be used to treat osteoarthritis.

Questions To Ask Your Doctor or Pharmacist About Medicines

• How often should I take this medicine?
• Should I take this medicine with food or between meals?
• What side effects can I expect?
• Should I take this medicine with the other prescription medicines I take?
• Should I take this medicine with the over-the-counter medicines I take?

Learn About Your Medications

All medicines used to treat osteoarthritis have potential side effects, so it is important for people to learn about the medicines they take. Even over-the-counter drugs and dietary supplements should be checked. Several groups of patients are at higher risk for side effects from NSAIDs, such as:

• people with a history of peptic ulcers or digestive tract bleeding
• people taking oral corticosteroids or anticoagulants (blood thinners)
• smokers
• people who consume alcohol

Some patients may be able to help reduce side effects by taking some medicines with food. Others should avoid stomach irritants such as alcohol, tobacco, and caffeine. Some patients try to protect their stomachs by taking other medicines that coat the stomach or block stomach acids. These measures help, but they are not always completely effective.

Go On To Part 5 --- Guide To Osteoarthritis --->

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