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Medications
Medications for rheumatoid arthritis can relieve its symptoms and slow or halt its progression. They contain:

Nonsteroidal anti-inflammatory drugs (NSAIDs). This assemble of medications, which includes aspirin, helps relieve both pain and inflammation if you take the drugs regularly. NSAIDs that are available over-the-counter contain aspirin, ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve). These are available at higher dosages, and additional NSAIDs are available by prescription — such as ketoprofen, naproxen (Anaprox, Naprosyn), tolmetin (Tolectin), diclofenac (Voltaren), nabumetone (Relafen) and indomethacin (Indocin). Taking NSAIDs can lead to side things such as indigestion and stomach bleeding. Additional potential side things may contain hurt to the liver and kidneys, ringing in your ears (tinnitus), fluid retention and high blood pressure. NSAIDs, except aspirin, may also increase your risk of cardiovascular events such as heart attack or stroke.
COX-2 inhibitors. This class of NSAIDs may be less damaging to your stomach. Like additional NSAIDs, COX-2 inhibitors — such as celecoxib (Celebrex) — suppress an enzyme called cyclooxygenase (COX) that’s active in joint inflammation. Additional types of NSAIDs work against two versions of the COX enzyme that are bestow in your body: COX-1 and COX-2. But, there’s evidence that by suppressing COX-1, NSAIDs may cause stomach and additional problems because COX-1 is the enzyme that protects your stomach lining. Unlike additional NSAIDs, COX-2 inhibitors suppress only COX-2, the enzyme involved in inflammation. Side things may contain fluid retention and causing or exacerbating high blood pressure. Furthermore, this class of drugs has been linked to an increased risk of heart attack and stroke.
Corticosteroids. These medications, such as prednisone and methylprednisolone (Medrol), reduce inflammation and pain, and slow joint hurt. In the small term, corticosteroids can make you feel dramatically better. But when used for many months or years, they may become less effective and cause serious side things. Side things may contain simple bruising, thinning of bones, cataracts, weight gain, a round face and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication.
Disease-modifying antirheumatic drugs (DMARDs). Physicians prescribe DMARDs to limit the amount of joint hurt that occurs in rheumatoid arthritis. Taking these drugs at early stages in the development of rheumatoid arthritis is especially vital in the try to slow the disease and save the joints and additional tissues from permanent hurt. Because many of these drugs act slowly — it may take weeks to months before you notice any benefit — DMARDs typically are used with an NSAID or a corticosteroid. While the NSAID or corticosteroid handles your immediate symptoms and limits inflammation, the DMARD goes to work on the disease itself. Some commonly used DMARDs contain hydroxychloroquine (Plaquenil), the gold compound auranofin (Ridaura), sulfasalazine (Azulfidine), minocycline (Dynacin, Minocin) and methotrexate (Rheumatrex). Additional forms of DMARDs contain immunosuppressants and tumor necrosis factor (TNF) blockers.
Immunosuppressants. These medications act to tame your immune system, which is out of control in rheumatoid arthritis. In addition, some of these drugs attack and eliminate cells that are associated with the disease. Some of the commonly used immunosuppressants contain leflunomide (Arava), azathioprine (Imuran), cyclosporine (Neoral, Sandimmune) and cyclophosphamide (Cytoxan). These medications can have potentially serious side things such as increased susceptibility to infection.
TNF blockers. These are a class of DMARDs known as biologic response modifiers. TNF is a cytokine, or cell protein, that acts as an inflammatory agent in rheumatoid arthritis. TNF blockers, or anti-TNF medications, target or check this cytokine and can help reduce pain, daylight stiffness and tender or swollen joints — usually within one or two weeks after treatment starts. There is evidence that TNF blockers may halt progression of disease. These medications often are taken with methotrexate. TNF blockers approved for treatment of rheumatoid arthritis are etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira). Potential side things contain booster site irritation (adalimumab and etanercept), worsening congestive heart failure (infliximab), blood disorders, lymphoma, demyelinating diseases, and increased risk of infection. If you have an active infection, don’t take these medications.
Interleukin-1 receptor contender (IL-1Ra). IL-1Ra is another type of biologic response modifier and is a recombinant form of the naturally occurring interleukin-1 receptor contender (IL-1Ra). Interleukin-1 (IL-1) is a cell protein that promotes inflammation and occurs in excess amounts in people who have rheumatoid arthritis or additional types of inflammatory arthritis. If IL-1 is prevented from binding to its receptor, the inflammatory response decreases. The first IL-1Ra that has been approved by the Food and Drug Administration for use in people with moderate to severe rheumatoid arthritis who haven’t responded adequately to conventional DMARD therapy is anakinra (Kineret). It may be used alone or in amalgamation with methotrexate. Anakinra is given as a day after day self-administered booster under the skin. Some potential side things contain booster site reactions, decreased white blood cell counts, headache and an increase in upper respiratory infections. There may be a slightly higher rate of respiratory infections in people who have asthma or chronic obstructive pulmonary disease. If you have an active infection, don’t use anakinra.
Abatacept (Orencia). Abatacept, a type of costimulation modulator approved in late 2005, reduces the inflammation and joint hurt caused by rheumatoid arthritis by inactivating T cells — a type of white blood cell. People who haven’t been helped by TNF blockers might consider abatacept, which is administered monthly through a vein in your arm (intravenously). Side things may contain headache, nausea and mild infections, such as upper respiratory tract infections. Serious infections, such as pneumonia, can occur.
Rituximab (Rituxan). Rituximab reduces the number of B cells in your body. B cells are involved in inflammation. Though formerly approved for use in people with non-Hodgkin’s lymphoma, rituximab was approved for rheumatoid arthritis in early 2006. People who haven’t found relief using TNF blockers might consider using rituximab, which is usually given along with methotrexate. Rituximab is administered as an infusion into a vein in your arm. Side things contain flu-like cryptogram and symptoms, such as fever, chills and nausea. Some people experience extreme reactions to the infusion, such as problem breathing and heart problems.
Antidepressant drugs. Some people with arthritis also experience symptoms of depression. The most common antidepressants used for arthritis pain and nonrestorative sleep are amitriptyline, nortriptyline (Aventyl, Pamelor) and trazodone (Desyrel).
Surgical or additional procedures
Although a amalgamation of medication and self-care is the first course of action for rheumatoid arthritis, additional methods are available for severe cases:

Prosorba discussion. This blood-filtering technique removes certain antibodies that say to pain and inflammation in your joints and muscles and is usually performed once a week for 12 weeks as an outpatient procedure. Some of the side things contain exhaustion and a brief increase in joint pain and swelling for the first few days after the treatment. The Prosorba discussion treatment isn’t recommended if you’re taking angiotensin-converting enzyme (ACE) inhibitors or if you have heart problems, high blood pressure or blood-clotting problems.
Joint replacement surgery. For many people with rheumatoid arthritis, medicines and therapies can’t prevent joint destruction. When joints are relentlessly hurt, joint replacement surgery can often help restore joint function, reduce pain or right a deformity. You may need to have an entire joint replaced with a metal or plastic prosthesis. Surgery may also involve tightening tendons that are too loose, loosening tendons that are too tight, fusing bones to reduce pain or removing part of a diseased bone to improve mobility. Your doctor may also remove the inflamed joint lining (synovectomy).