Arthrosis, arthritis are diseases of the joints that are accompanied by pain. Treatment of arthrosis and arthritis with medications must necessarily be supplemented with non-drug therapy, but first of all it is necessary to relieve pain and inflammation. Painkillers for arthritis and arthrosis best cope with this task. Their list is extensive; the optimal drug is selected taking into account the severity of symptoms and existing contraindications. Antibiotics are not always prescribed for arthritis and arthrosis; for arthrosis, they are extremely rare. There are remedies that are used in the treatment of both diseases, as well as specific ones for arthritis and arthrosis, what is the difference, how to treat these diseases?
Arthritis is an inflammation of the joint, which can occur in acute or chronic form. Arthrosis is a degenerative disease in which articular cartilage is gradually destroyed and bones are deformed. Arthrosis can develop against the background of arthritis or be accompanied by secondary synovitis - inflammation of the synovial membrane. But for arthrosis itself, inflammatory processes are not typical. Pain in arthrosis is predominantly mechanical, occurs under load, is dull, aching. With arthritis, joint pain is inflammatory, more acute and intense, and occurs at rest, often at night. The same medications are used for pain in both diseases:
Antibiotics for arthritis and arthrosis are used only when the disease is of an infectious bacteriological nature. Arthrosis is an aseptic disease; antibiotic therapy may be indicated in the following cases:
Also, antibiotics for arthritis and arthrosis can be prescribed to prevent postoperative complications if surgical treatment was carried out.
Some NSAIDs have a more pronounced anti-inflammatory effect, while others have an analgesic effect. Ketoprofen, Ketorolac are effective medicines for pain; Indomethacin has a predominant anti-inflammatory effect. Non-steroidal anti-inflammatory drugs are divided into selective and non-selective. Ibuprofen, Ketoprofen, Indomethacin are non-selective drugs that are contraindicated for people with gastroenterological problems. Nimesulide, Movalis (meloxicam) are new generation NSAIDs, selective COX inhibitors with fewer side effects and contraindications. NSAIDs also differ in the form of release.
Non-steroidal anti-inflammatory drugs for arthritis and arthrosis are used mainly orally. Effective tablets for arthritis - Diclofenac, Indomethacin, Meloxicam. Systemic treatment can be supplemented with local treatment using cream, gel, ointment. Combined ointments for arthritis and arthrosis are also effective; they contain salicylates and irritating components that have a distracting effect and relieve pain. Less commonly, nonsteroidal anti-inflammatory drugs for arthritis are used in the form of intramuscular injections. Injections for arthritis are given mainly in acute cases of gouty, rheumatoid form.
Hydrocortisone, Prednisolone, Celeston, Betamethasone and a number of other glucocorticosteroids are used primarily as injections for arthrosis and arthritis with a pronounced inflammatory process. They perfectly relieve swelling and relieve inflammation, but their analgesic effect is less pronounced. Therefore, for arthrosis, they are prescribed only in extreme cases, usually if the disease is complicated by synovitis and NSAID therapy does not give the desired effect. These medications for arthritis and arthrosis are not intended for long-term and frequent use. Treatment is carried out according to the scheme, depending on the drug, breaks are taken between injections from 1 to 4 weeks, the course usually requires 3-5 injections.
The effect is most quickly achieved if the drug is injected directly into the joint cavity. But this is a complex, traumatic and painful manipulation. To reduce pain, GCA is usually mixed with a local anesthetic (lidocaine, novocaine). It is important to maintain complete sterility. The dose of the drug depends on the size of the joint. After intra-articular injections for arthritis, the patient must make several movements in the joint so that the drug is better distributed throughout the cavity. In case of severe deformation of the joint, which is typical for advanced forms of the disease, injections are given periarticularly, that is, into the soft tissue around the joint. It takes longer to achieve a therapeutic effect.
Despite the high effectiveness of hormonal drugs, they are prescribed only if there are compelling indications. If after 2-3 injections there is no improvement, the drug is discontinued. Glucocorticoids aggravate the destruction of articular cartilage during arthrosis and osteoporosis, which is accompanied by arthritis. They also have a negative effect on other organs and systems; long-term use can lead to:
Usually, NSAIDs with pronounced analgesic activity are sufficient to relieve joint pain. ESCEO recommends taking paracetamol in the early stages of arthrosis for moderate pain. This drug is a selective inhibitor of cyclooxygenase, which has several isoforms. if NSAIDs suppress the activity of COX-1 and/or COX-2, then paracetamol suppresses only COX-3. This determines the pronounced antipyretic effect of the drug; it is also used as an analgesic. But paracetamol does not have an anti-inflammatory effect, so these tablets for arthritis do not help. The once popular non-narcotic analgesic Metamizole, better known as Analgin, can also relieve mild and moderate joint pain, but in most countries it has been abandoned due to the abundance of side effects.
In the later stages, both diseases occur with intense, constant pain that cannot be relieved with NSAIDs. In this case, they resort to reserve therapy and prescribe a potent medicine for pain - narcotic or combined analgesics. In the treatment of arthralgia (joint pain), only weak opioids (Oxycodone, Methadone, Tramadol) are used. The drugs are used both orally and by injection. Such treatment can be carried out only as prescribed by a doctor and under constant medical supervision; opioid analgesics depress respiratory and cardiac functions and are addictive.
There are other remedies for joint pain:
There is a specific medicine for arthrosis, which is not used in the treatment of arthritis. This is Diacerein, an anti-inflammatory drug. Unlike other NSAIDs, it does not suppress the activity of COX (cyclooxygenase), but interleukin-1, an inflammatory protein that has a destructive effect on cartilage tissue. Pharmacists classify it as a non-steroidal anti-inflammatory drug, but its action is closer to chondroprotectors. Chondroprotectors are a group of drugs that contain components of cartilage tissue, mainly glucosamine and chondroitin sulfate, and thereby slow down the destruction of articular cartilage. Sometimes this group includes synovial fluid prosthesis, hyaluronic acid. This medicine is not used for arthritis, since it is ineffective in the presence of inflammatory effusion in the joint cavity.
Chondroprotectors have moderate analgesic activity. Injections of hyaluronic acid into the joint provide pain-free movement. Muscle relaxants relieve muscle spasms and pain. But all these drugs that are used in the treatment of arthrosis are not analgesics.
The list of specific medications for arthritis is much wider, since there are many types of this disease, each with its own treatment with medications:
There are many drugs that can relieve pain from arthritis and arthrosis. They are used orally, externally, or in the form of injections. Most of these drugs place an undesirable medicinal burden on the body, so if possible, pain should be relieved by non-drug methods, using physiotherapeutic procedures. It should also be remembered that pain-relieving anti-inflammatory drugs are intended solely for symptomatic treatment. Therapeutic measures for joint diseases should not be limited to their intake; it is also necessary to take medications that affect the cause and mechanism of development of the disease.
The main symptom of rheumatoid arthritis is inflammation of the joints. Usually the pain makes itself felt while walking or lifting heavy objects. This happens because when stressed, the affected joint swells, changes shape and loses mobility. The area of inflammation may turn red and develop a fever.
According to doctors, drug treatment for arthritis is most often prescribed with various groups of drugs. A brief overview of the characteristics and recommendations for taking medications for arthrosis helps patients take the treatment process seriously and responsibly.
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The review of drugs contains the most effective drugs used in drug therapy. All of them are aimed at eliminating inflammation, mitigating the symptoms of the disease, and regenerating joint functions.
An effective local medicine for arthritis. It suppresses inflammatory reactions in joints well, reduces pain and relieves swelling. Regular external use eliminates morning stiffness and swelling of joints, and helps increase range of motion. Medicine for joint pain is prescribed for use several times a day. The ointment is squeezed out with a tube 20-50 mm long and thinly rubbed into the skin of painful areas. The maximum daily dose is 150 mm for adults and 75 mm for children.
Contraindications for use:
For patients suffering from allergic rhinitis, bronchial asthma, polyps in the nasal mucosa, the medicine is prescribed with great caution.
2. Voltaren emulgel.
A non-steroidal external drug is characterized by an anti-inflammatory and analgesic effect. Prescribed for arthritis of the knee joint, osteoarthritis. This medicine is also recommended in such cases:
Prescribed to adults and children over 12 years of age. It is applied to the skin in the area of inflammation and lightly rubbed. A single dose of emulgel depends on the size of the painful area. The effectiveness and advisability of further use of Voltaren emulgel are assessed 2 weeks after the start of therapy.
The topical medicine for rheumatoid arthritis contains diclofenac. For this reason, it is prescribed with caution to patients with diseases of internal organs, bronchial asthma or heart failure. The use of the drug by elderly people and women in the first and second trimester of pregnancy should only be done with the approval of the attending physician.
A selective anti-inflammatory drug that is prescribed when long-term pain relief is needed (psoriatic or rheumatoid arthritis, osteoarthritis, ankylosing spondylitis). The medicine rarely causes side effects from the gastrointestinal tract and practically does not cause complications.
The active substance in Movalis is meloxicam. The drug is available in three forms:
For ankylosing spondylitis, arthritis of the knee joint, toes, and hands, the maximum daily dose is 15 mg (1-2 tablets). Depending on the duration of treatment and effectiveness, it can be halved.
4. Minocycline (Minocin).
This medicine treats arthritis caused by a bacterial infection. The antibiotic successfully suppresses the growth of pathogenic flora that provokes inflammation in the joints. In addition, it prevents the appearance of purulent formations (abscesses, cellulitis) and prevents the spread of infection in the body. The drug also reliably blocks metalloproteinase enzymes that damage connective tissue and prevents joint destruction.
Antibacterial therapy is indicated for patients suffering from gonorrheal, purulent, tuberculous or rheumatoid arthritis. Minocycline is a slow-acting drug. To achieve a positive effect, it is necessary to take it for a long time. When treating arthritis of the toes, hands, knee and ankle joints, doses of 100 mg per day are prescribed (one tablet twice a day).
The drug belongs to the category of a broad group of chondroprotectors. Prescribed for the treatment of rheumatoid, reactive and other types of arthritis of the joints. The remedy has a positive effect on phosphorus-calcium metabolism in cartilage tissues and acts as a lubricating coating for joints. When used externally, Chondrogard helps slow the development of osteoarthritis, stabilizes metabolism in hyaline tissue, and stimulates the restoration of articular cartilage. The medicine is used in the form of a solution for intramuscular injection in ampoules. 1 ml contains 100 mg of chondroitin sulfate.
The steroid drug is prescribed as an addition to the main treatment with non-steroidal drugs. Most often recommended for arthritis of the ankle, toes and hands. The medicine is available in the form of tablets of 5 mg and solution for injection in ampoules of 30 mg. At the beginning of treatment, 20-75 mg is used. Then gradually reduce the dose to 5-25 mg. The duration is determined by the doctor. Prednisolone use should be limited to the minimum effective treatment volume.
The etiology of one of the most complex joint diseases is still considered unclear. The first symptoms may appear after injuries, infections, stress, hormonal imbalance, physical or emotional fatigue. The pathology can affect any joint, although in practice arthritis of the toes, hands, and wrists is most common.
The main difficulty of treatment is that the disease often spreads to several joints at once. The active stage of arthritis constantly alternates with periods of remission (decreased severity of the pathological process). Effective drug treatment consists of two stages:
Treatment of the active stage of arthritis is carried out under the supervision of a rheumatologist. Basically, it is aimed at pain relief and reducing inflammation in the joints. For these purposes, different groups of drugs are used.
1. Nonsteroidal anti-inflammatory drugs (NSAIDs), which effectively inhibit the enzyme that controls physiological and inflammatory reactions. The most commonly prescribed medications are Diclofenac, Indomethacin, Naproxen, and Ibuprofen. They are produced in the form of injection solutions, tablets, suppositories, ointments, and gels.
These drugs for the treatment of arthritis have some features of administration:
2. Selective anti-inflammatory drugs (cyclooxygenase-2 inhibitors) - drugs that suppress the enzyme that supports the inflammatory process in the joints. These include Meloxicam, Piroxicam, Celebrex, Nimulid. They are available in the form of injections and tablets. Selective drugs have few side effects, so they are prescribed for arthritis of the knee joint or fingers of the extremities to patients with diseases of the gastrointestinal tract, liver and other internal organs.
3. Glucocorticoids (GCST) – hormones of natural or synthetic production. They take part in various types of metabolism and have immunosuppressive and anti-inflammatory properties. In practice, Prednisolone and Methylprednisolone are most often used.
When treating arthritis of the toes, hands, or ankles with glucocorticoid hormones, the physician must take several factors into account:
To minimize side effects, it is recommended to start taking hormonal drugs with small doses, gradually increasing the volume. During treatment, it is necessary to maintain a daily rhythm of taking the medication. After the therapeutic effect is achieved, the amount of the drug is reduced little by little every 5-7 days to the minimum maintenance dose or completely stopped.
Biological therapy is an innovative method for eliminating arthritis of the knee, fingers and ankle. The use of biologically active components blocks the actions of tumor necrosis factor (TNFa) in joints. The most commonly used biological drugs are Inflikimab, Adalimumab, and Etanercept. The main disadvantage is the high price. In addition, long-term use leads to a decrease in immunity.
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For the treatment of rheumatoid arthritis, basic medications are mainly used. Typically, in such cases, drugs are used that can be divided into 5 main groups:
Standard medications used to treat arthritis prevent destruction of the articular surfaces of the joints, and they are also used as a treatment for concomitant autoimmune diseases, such as systemic lupus erythematosus, ankylosing spondylitis and Sjögren's syndrome. The drugs included in this drug group prevent the development of arthritis, but do not eliminate its manifestations (this is how they differ from NSAIDs).
Basic medications have a long-term effect - 3-6 months may pass from the start of therapy until the first changes towards improvement appear. Typically, these drugs are prescribed together with NSAIDs and glucocorticosteroids.
To select the necessary basic medications, it takes some time to check the effectiveness of several groups of drugs, which helps to achieve the maximum effect. If the medications are well tolerated, you should complete a full treatment course, waiting out the initial stage of therapy, during which obvious symptoms of improvement are not yet observed.
If the drugs are selected successfully and the treatment produces results, basic drugs are used for many years.
Immunomodulatory drugs are usually used in cases of advanced, severe forms of the disease, when other drugs do not provide the desired effect. But you need to understand that when using these drugs, to achieve the desired result, you need complex treatment in combination with other medications.
Arava is a basic medicine with antirheumatic action. The drug has anti-inflammatory, immunomodulatory, and antiproliferative effects. It is used in the treatment of adult patients suffering from active rheumatoid arthritis. The medicine helps reduce the severity of the symptoms of the disease, and also prevents the destruction of the structure of the articular surfaces of the joints.
Plaquenil has an immunosuppressive and anti-inflammatory effect on the body in rheumatoid arthritis (its chronic and acute forms). The active substance of the drug, hydroxychloroquine, has cumulative activity. The effect of taking the medicine may appear only after a few weeks, but side effects may occur much earlier. To achieve the desired result, you need to take the medicine for several months. If no objective improvement is observed within six months of taking Plaquenil, you should stop using it.
Neoral is an immunosuppressive drug, polymyxin, which includes 11 amino acids. Used to treat rheumatoid arthritis (in active, severe forms, when standard long-acting antirheumatic drugs do not have the required effect or when they cannot be used).
In the treatment of rheumatoid arthritis, the drug Imuran has a strong therapeutic effect without combination with corticosteroids. The medicine has an immunosuppressive effect.
Cytoxan is an antitumor drug that has an alkylating effect, in addition to also having an immunosuppressive effect. It is used for psoriatic and rheumatoid arthritis.
Analgesics help reduce pain, but they cannot relieve inflammation in the joints - this distinguishes them from NSAIDs. Painkillers are usually prescribed to treat severe forms of arthritis with severe painful symptoms, such as osteoarthritis. These medicines may contain substances such as paracetamol, but also codeine or aspirin, or other similar substances in combination.
Diclofenac is usually prescribed to treat arthritis. The use of aspirin is sometimes accompanied by side effects from the gastrointestinal tract in the form of pain and discomfort in the abdomen, so you should not take it if you have a stomach ulcer, gastritis, or on an empty stomach. It is advisable to take these medications with milk. Codeine may cause constipation or nausea. In general, any medicine should be prescribed by the attending physician after a thorough examination of the patient in order to assess the advisability of using certain medications, taking into account the presence of concomitant diseases that he has in addition to arthritis.
Treatment for osteoarthritis usually begins with the use of aspirin. Although this drug is successfully used for many medicinal purposes, it is not effective enough for the treatment of arthritis and arthrosis. It is often replaced with other medications.
It should be noted that aspirin should be prescribed with caution if the patient has blood diseases, because this drug reduces blood clotting.
NSAIDs (among these drugs the most well-known are indomethacin, ketoprofen, diclofenac, as well as piroxicam, ibuprofen and butadione) are prescribed to eliminate the inflammatory process and pain in the joints, as well as their swelling. These drugs are the best known and most commonly used group of drugs used for arthritis. They successfully cope with the main manifestations of the disease, but cannot resist the destruction of joints, and therefore are not able to influence the development and course of the disease.
NSAIDs prevent the production of hormone-like elements, as well as prostaglandins, which cause the development of the inflammatory process and the appearance of pain. These drugs should be used with caution, as they can lead to erosive and ulcerative complications in the stomach. Sometimes they are prescribed in combination with other medications that reduce the effect of non-steroidal anti-inflammatory drugs on the gastrointestinal tract.
Diclofenac is one of the most popular and well-known NSAIDs. This drug helps in the treatment of arthrosis. It combines effective anti-inflammatory properties, as well as a strong analgesic effect.
Ibuprofen is used in the treatment of joint diseases. It is less effective than indomethacin in terms of its analgesic and anti-inflammatory properties, but it is much better tolerated by patients without causing severe adverse reactions.
Indomethacin has highly effective anti-inflammatory properties and also has a strong analgesic effect. The drug is available in 25 mg tablets. Although it is considered one of the most effective remedies for arthrosis or arthritis, it must be borne in mind that this medicine has an extensive list of side effects.
Ketoprofen is an NSAID, a derivative of arylcarboxylic acid. The medicine has antipyretic, analgesic, and anti-inflammatory properties. It helps reduce pain in the joints both at rest and during movement, reduces their swelling and stiffness in the morning, and also increases the range of movements carried out by the joints.
Movalis is one of the most famous drugs, the active ingredient of which is meloxicam. The main advantage of this medicine is that it can be used for long courses (several months or even years), but only under the supervision of the attending physician. The drug is available in tablet form. This form of manufacture allows the medicine to act for a long time, so taking only 1 tablet per day is sufficient. You can take it both in the morning and before bed after meals.
Celecoxib has powerful analgesic and anti-inflammatory properties, helping to get rid of pain from arthrosis and arthritis, and at the same time causes almost no adverse reactions from the gastric mucosa and the gastrointestinal tract in general. This drug is available in capsule form with a dosage of 200 or 100 mg.
Nimesulide has a powerful anti-inflammatory and analgesic effect, helping to eliminate the main symptoms of arthrosis. It also has antioxidant properties and helps reduce the activity of elements that have a destructive effect on cartilage tissue, proteoglycans, and collagen fibers.
Etoricoxib is available in tablets under the trade name Arcoxia. When taking the drug in low dosages (no more than 150 mg/day), it does not cause serious side effects and does not affect the gastric mucosa (like other drugs from the COX-2 drug group). During the treatment of arthrosis, the medicine is prescribed in a dosage of 30-60 mg/day.
Since the drug of this group can negatively affect the organs of the cardiovascular system, at the initial stage of use it is necessary to perform regular blood pressure checks.
Corticosteroids are drugs that have the properties of the hormonal substance cortisol. In the body it is produced by the adrenal cortex. Cortisol affects various systems in the body, including the immune system, among others.
Corticosteroids reduce prostaglandin levels and also affect T and B lymphocytes, which are involved in immune reactions. In this way, inflammation processes in the joints are influenced.
These medications are fast-acting and are often used for arthritis and other musculoskeletal diseases. Compared to NSAIDs, corticosteroids have more powerful anti-inflammatory properties, and they also effectively cope with autoimmune diseases, in which it is necessary to prevent the development of autoimmune aggression against the body’s own tissues. But it should be borne in mind that due to immunosuppression, the body’s vulnerability to any infections increases - this is the main disadvantage of this group of drugs.
The active component of the drug is betamethasone, a synthetic systemic glucocorticoid. Since betamethasone acts as a synthetic derivative of prednisolone, it has powerful antiallergic, anti-inflammatory, and antirheumatic properties. Celeston has increased GCS activity, as well as a weak mineralocorticoid effect.
Prednisolone is a synthetic substance that may have similar characteristics to the hormones hydrocortisone and cortisone produced by the adrenal glands. When used orally, this component is 4-5 times more active than cortisone and 3-4 times more active than hydrocortisone. In addition, the difference between prednisolone and these substances is that it does not cause noticeable water and sodium retention, and also rarely causes hyperkalemia. The drug also has powerful anti-inflammatory properties.
Diprospan is a medicine from the group of glucocorticoids that has an immunosuppressive, anti-allergenic and anti-inflammatory effect on the body. This drug is used to treat autoimmune diseases of the connective tissue and musculoskeletal system (such as osteoarthritis or rheumatoid arthritis).
A synthetic glucocorticoid drug used to treat rheumatoid arthritis (also ankylosing spondylitis and juvenile rheumatoid arthritis).
Metypred inhibits the development of tissue reactions to various agents (mechanical and thermal, chemical and immunological, as well as infectious). This allows glucocorticoids to affect the symptoms of the disease, reducing its manifestations, but without affecting the very cause of its occurrence. Methylprednisolone has strong anti-inflammatory properties, which are at least 5 times higher than those of hydrocortisone.
Nonsteroidal anti-inflammatory drugs include joint medications that reduce inflammation in the body. Inflammation is a reaction of body tissues to external mechanical, physical or infectious stimuli. The drugs are aimed at relieving inflammation and pain. Non-steroidal anti-inflammatory drugs block the enzyme cyclogenesis (prostaglandins) in the body. Cyclogenesis (prostaglandin) is a hormone-like chemical that fights by increasing temperature and dilating blood vessels. By reducing the production of prostaglandins, the drugs will relieve fever, reduce inflammation, and relieve symptoms of pain. Typical nonsteroidal anti-inflammatory drugs are often used to treat certain types of arthritis and other musculoskeletal disorders.
A new class of anti-inflammatory drugs is immune-selective. Based on the recognition that the immune, nervous and endocrine systems interact in complex ways to control inflammation.
Pain medications are used to control acute and chronic pain conditions. Non-steroidal anti-inflammatory drugs for the treatment of joint diseases are taken with plenty of liquid, without chewing them. There are also soluble forms of painkillers that completely dissolve in liquid.
Diclofenac is a pain reliever. A drug such as Diclofenac also has an anti-inflammatory effect, and therefore is an effective treatment for joints in all forms of arthritis. Diclofenac can be used both internally and externally, in the form of tablets and ointments. It acts quickly, usually half an hour is enough for the pain to begin to go away. By interacting with anticonvulsants and alcohol, the liver suffers severe damage. You should also not take Diclofenac with other NSAID drugs, as the side effects may increase significantly.
Possible side effects:
When taking the pills, there is a risk of stomach ulcers, less common is increased blood pressure and kidney dysfunction, which consists of an increased tendency to bleed. Seizures and breathing problems are rare. Diclofenac is not suitable for use by children and adolescents. Patients suffering from asthma should avoid taking it. If you have to take the medicine for a long time, regular monitoring of blood pressure, testing of liver and kidney functions is recommended.
Paracetamol is used both as monotherapy and in combination with other drugs. The analgesic and antipyretic drug was introduced in 1950 and is one of the most common, essential painkillers. It is released without a prescription. Paracetamol has medical uses for a variety of painful conditions, including arthritis of the joints. It is one of the first broad-spectrum drugs. To treat moderate to severe arthritis pain, it is used in combination with Tramadol or Codeine. The tablets are taken orally, but can be administered rectally or intravenously. The dosage of the drug for adults is calculated based on body weight. You can take the medicine no more than 4 times a day.
Ibuprofen is a non-steroidal anti-inflammatory and analgesic drug. Used for the symptomatic treatment of pain, fever and inflammation in acute joint inflammation (arthritis, gout, chronic polyarthritis, osteoarthritis, spondyloarthritis). The medicine is available in various forms such as tablets, capsules, granules, baby syrups, suppositories, ointments. When taking any other drugs in combination with Ibuprofen, you should be especially careful. Combination with other NSAIDs should be avoided. When Ibuprofen is used concomitantly with oral corticosteroids, anticoagulants such as warfarin, SSRIs (used to treat depression) or antiplatelet agents (Aspirin), there is a risk of bleeding or ulcers in the gastrointestinal tract. If such factors occur, further treatment should be stopped immediately. Ibuprofen should not be taken if you are allergic to the active substance or other component of the medicine. To be treated with Ibuprofen, the patient should not suffer from hypertension, diabetes, or high cholesterol.
Indomethacin is used as an anti-inflammatory drug, especially for acute rheumatic joint attacks. The drug effectively controls pain and inflammation in joints and muscles. It has antipyretic and blood thinning properties. Indomethacin is available only with a doctor's prescription. The inhibitory effect of the drug begins immediately after administration. The effect can last up to 8 hours.
It is not recommended to use Indomethacin on a regular basis, as it can lead to the following side effects:
Gastrointestinal complaints improve when the medication is stopped. Taking the drug is strictly prohibited during pregnancy, lactation, hypertension and the risk of bleeding. In any case, regular blood pressure monitoring, liver function tests and blood sampling for general analysis should be carried out.
Methotrexate is a basic antirheumatic drug used to treat rheumatoid and psoriatic arthritis of the joints. In addition, Methotrexate is used to treat various malignant tumors.
Trade names of Methotrexate:
The active substance of Methotrexate, methotrexate disodium, has an anti-inflammatory effect. Improvement occurs after 4–8 weeks of using the medicine for arthritis. After stopping taking the drug, it can lead to a relapse. If the medicine comes into contact with the skin or mucous membrane, rinse the area with plenty of water.
Side effects depend on the dose taken and duration of use of Methotrexate. The most common side effects:
While using Methotrexate, the patient should visit a doctor regularly for check-ups, especially during the first 6 months of use.
Corticosteroids are one of 50 groups of steroid hormones produced in the adrenal cortex. The most famous corticosteroid is Cortisone. It regulates many metabolic processes in the body. For a long time it was considered a “miracle drug” against all diseases. Corticosteroids suppress inflammation, improve blood circulation, stimulate acid production in the stomach and have a positive effect on the immune system. Natural corticosteroids are much weaker compared to artificially produced ones.
Prednisolone is an active drug from this group. The purpose of Prednisolone is to inhibit inflammation and reduce joint swelling. It has anti-inflammatory and antiallergic effects, affects lipid metabolism and carbohydrate metabolism.
Analgesics relieve pain but not inflammation, unlike nonsteroidal anti-inflammatory drugs (NSAIDs). They are most often prescribed to treat osteoarthritis and some other painful but non-inflammatory forms of arthritis. These medications may contain paracetamol, aspirin, codeine, or a combination of these. When these drugs are used correctly, side effects are rare. In any case, you should not exceed the dose recommended by your doctor and use the drug for a long time without consulting a doctor.
NSAIDs are used to relieve inflammation and swelling, reduce pain and joint stiffness. This is the largest and most widely used group of drugs for the treatment of arthritis; the class of non-steroidal drugs includes more than 40 medicinal items. They are effective in relieving the symptoms of arthritis, but cannot slow down the process of joint destruction.
NSAIDs block the release of prostaglandins and hormone-like substances, which cause inflammation and pain. If therapy with non-steroidal anti-inflammatory drugs is effective, within a week patients feel an increase in joint mobility and a decrease in pain. The most popular NSAIDs are Ketorolac (Ketanov), Diclofenac (Voltaren, Ortofen, Naklofen), Indomethacin, Analgin, Piroxicam, Naproxen, Ibuprofen. and Meloxicam.
The side effect of these drugs is expressed in erosive and ulcerative lesions of the stomach and inhibition of platelet formation. In addition to damage to the gastrointestinal tract, nephrotoxic, hepatotoxic, ototoxic and other side effects are also characteristic. To improve the tolerability of the reduced effect on the gastrointestinal tract, it is recommended to combine the use of non-steroids with gastroprotectors, reduce the dose, use enteric-soluble forms, switch to intramuscular, rectal or local administration.
These are products that improve the structure of cartilage. They help strengthen cartilage tissue and thereby slow down the progression of arthrosis. Chondroprotectors are taken in long courses, for at least 3 months. It is necessary to carry out treatment 2 times a year.
Chondroprotectors come in capsules, tablets and powders (Structum, Teraflex, Arthra, Chondrosamine), and in the form of ointments (Chondroitin Akos, Chondroart, Chondroxide). In hospital settings, intra-articular injections of Ostenil and Fermatron are performed. Dietary supplements - Honda protectors (Honda capsules, ArthroStopPlus), unlike medications, have a lower content of active ingredients.
In the treatment of arthritis, vitamin monopreparations (folic acid, nicotinic acid, nicotinamide, etc.) or antioxidant complexes (Triovit, Tri-vit, Antioxicaps Neurobex, Neurorubin, Milgamma) are also used. Necessary minerals for joint diseases are sulfur, selenium, zinc, manganese, copper, molybdenum. Immunomodulatory drugs are used to treat severe forms of arthritis.
The treatment regimen for post-traumatic or infectious arthritis is generally clear - it is:
The difficulty of treating rheumatoid arthritis is that with this disease, in addition to the need to combat the inflammatory process, there is a need to regulate immunological reactivity with the help of basic drugs
In this regard, rheumatoid arthritis must be treated with first, second and third line drugs, and treatment is delayed for a long period:
Today our pharmaceutical industry produces an abundance of anti-inflammatory medications.
The action of NSAIDs is based on the inhibition of cyclooxygenase, which is responsible for the synthesis of participants in inflammatory processes - prostaglandins
NSAIDs include traditional COX-1 inhibitors, which have been used for a long time, and newer COX-2 inhibitors, designed for longer use and with fewer side effects.
NSAIDs are available in the form of:
Before use, be sure to read the instructions, which should indicate:
Among the first-line NSAIDs, the following drugs are known:
All of the above NSAIDs have a number of side effects that prevent their long-term use:
COX-2 inhibitors include the following NSAIDs:
These drugs can be used for a long time, since they have fewer complications, however, the opinion of rheumatologists regarding the effectiveness of these drugs in the treatment of rheumatoid arthritis is ambiguous. We must not forget that all NSAIDs (inhibitors of both COX-1 and COX-2) only affect the symptoms, but not the nature of the disease itself. Therefore, they are recommended to be used in combination with basic products.
The basic drugs include the following basic drugs:
If first-line drugs turn out to be ineffective, and rheumatoid inflammation in the joints does not recede, then they resort to stronger drugs belonging to the group of glucocorticoid drugs - GCS. The effectiveness of these drugs is explained not only by their anti-inflammatory properties, but also by their partial immunosuppressive activity
GCS treatment is carried out both local and systemic:
The effect of cortisol is enhanced by simultaneous injection of an immunosuppressant into the joint: for example, cyclophosphamide - from 100 to 200 mg
These drugs lengthen the intervals between courses of intra-articular injections
The effect of taking GCS occurs very quickly, but disappears just as quickly after GCS is discontinued.
Corticosteroids are prescribed with great caution to children and adolescents, as well as the elderly.:
Third-line drugs include cytostatics - aggressive and harmful drugs.
In the treatment of rheumatoid arthritis, such a scheme is rarely used:
Cytostatics include:
Therapy with cytostatic drugs is carried out in a hospital setting, with constant clinical and laboratory monitoring:
Therapy is combined with the use of immunomodulators, for example, levamisole.
Genetic engineering biological therapy (GEBT) in the treatment of arthritis is a targeted medicine that, with a minimum of consequences, can selectively destroy target molecules responsible for autoimmune inflammatory processes
These cells are recognized as:
Examples of such monoclonal drugs are respectively:
These biological drugs are used in combination:
GIBT is a very effective treatment for RA, but it is not without its drawbacks. These include: