There are literally dozens of medications available over-the-counter and by prescription to treat the various forms of arthritis. Your doctor can help you choose what drugs are best for your particular disease.

Topical Pain Relievers

These over-the counter drugs can provide quick pain relief for people with arthritis that is in just a few joints -- such as a hand or whose pain isn't severe.

Anti-Inflammatory Painkillers (NSAIDs)

These drugs, both over-the-counter and prescription, can be used to relieve the symptoms of arthritis (joint swelling, stiffness, and pain). Almost everyone with arthritis has taken or is taking one of these drugs.

Often these drugs are called nonsteroidal anti-inflammatory drugs or NSAIDs.

Narcotic Pain Relievers

Narcotic pain relievers help with pain but don't relieve joint inflammation. Often they are combined with Tylenol (acetaminophen) or an NSAID to enhance their effects. You can develop dependency on narcotic drugs if not used as directed, and they can cause constipation, urinary problems, and sedation.

Corticosteroids ("Steroids")

Steroids are powerful anti-inflammatory drugs that can treat many forms of arthritis including rheumatoid arthritis, plus lupus and other forms of inflammation such as vasculitis.

Although effective, steroids can have many side effects, especially when taken as a pill and use long term. Often, doctors try to avoid these problems by injecting the steroid into the affected joint or trying other medications in combination to keep the dose of steroids as low as possible.

Hyaluronan Injections

There are several versions of hyaluronan injections -- also called viscosupplementation -- that are used to treat osteoarthritis of the knee. They are injected directly into the joint. They have been shown to reduce pain in a knee affected by osteoarthritis, increasing mobility and allowing more activity.

Disease-Modifying Antirheumatic Drugs (DMARDs)

These drugs are often able to alter the course of some forms of inflammatory arthritis -- diseases such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis -- that can destroy the joints. Often these drugs are the first ones used for these diseases.

DMARDs work by interfering with or suppressing the immune system that attacks the joints in people with certain forms of inflammatory arthritis. Aggressive treatment of arthritis often involves using one or more DMARDs.

Although effective, DMARDs have a higher risk of serious side effects. It also often takes weeks for you to notice the benefits of taking a DMARD. Therefore, they are often combined with a faster working drug such as an NSAID, another painkiller, or steroids to help relieve some arthritis symptoms.

Biologic Therapy

Currently approved to treat certain forms of inflammatory arthritis such as psoriatic arthritis, rheumatoid arthritis, and ankylosing spondylitis, biologic response modifiers (biologics) work by altering the function of the immune system that attacks the joints.

These drugs must be administered by intravenous (by vein) infusion or by an injection and they are more expensive than other arthritis drugs.

Chemotherapy Medications

Chemotherapy, traditionally used as cancer treatment, helps people with certain inflammatory and autoimmune diseases because it slows cell reproduction and decreases certain products made by these cells that cause an inflammatory response to occur. The doses of medication used for rheumatic or autoimmune conditions are lower than the doses used for cancer treatment.

Gout Medicines

These drugs relieve the pain and swelling and reduce uric acid levels caused by gout.

Reviewed by the doctors at The Cleveland Clinic Department of Rheumatic and Immunologic Diseases.

WebMD Medical Reference provided in collaboration with the Cleveland Clinic

SOURCES: WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Arthritis: Topical Painkillers."
WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Anti-Inflammatory Painkillers and Arthritis."
WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Steroids to Treat Arthritis."
WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Arthritis: Disease Modifying Medications."
WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "New Treatments for Inflammatory Arthritis: Biologics."
WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Arthritis: Narcotic Pain Relievers."
WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Chemotherapy Drugs to treat Arthritis."
WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Hyaluronan Injections to Treat Osteoarthritis." WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Gout."

Reviewed by Brunilda Nazario, MD, MD on December 22, 2008

Edited by Marc C. Levesque, MD, PhD on February 01, 2007

'Portions of this page © The Cleveland Clinic 2000-2005

Osteoarthritis Guide

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Do You Have Fibromyalgia Pain?

Cymbalta is approved for the management of fibromyalgia.

Important Safety Information

Cymbalta^® (duloxetine HCl) is approved for the treatment of depression and generalized anxiety disorder, and for the management of diabetic peripheral neuropathic pain and fibromyalgia.

What should I talk about with my healthcare provider?

Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.

You should also know that:

Suicide is a known risk of depression and some other psychiatric disorders.
Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents, and young adults especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults over age 24, and risk decreased for those over age 65.
All patients starting therapy should be monitored appropriately and observed closely for new or worsening depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior.
Cymbalta^® is not approved for use in patients under age 18.

Who should NOT take Cymbalta?
You should not take Cymbalta if:

You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
You have uncontrolled narrow-angle glaucoma (an eye disease)
You are taking Mellaril^® (thioridazine)

What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, tell your healthcare provider:

about all of your medical conditions, including kidney problems, glaucoma, or diabetes
about your alcohol use
if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life threatening condition
if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant

While taking Cymbalta, tell your healthcare provider:

if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
before stopping Cymbalta or changing your dose
if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose. Your healthcare provider may periodically check your blood pressure while you are taking Cymbalta

If you have any questions, talk to your healthcare provider before taking Cymbalta.

What are the possible side effects of Cymbalta?

The most common side effect of Cymbalta was nausea. For most people who had it, the nausea was mild to moderate. Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and, increased sweating. This is not a complete list of side effects.

Safety Information and Boxed Warning | Prescribing Information | Medication Guide