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Biologic Drugs continued...

Many biologics block TNF, a chemical your body makes that causes inflammation. Other biologics target other chemicals (such as IL-1, IL-6, or “Janus kinases”) or immune system cells (such as T or B cells).

How you take them: You may take biologics by injection at home, by IV in a medical center, or as a pill. Depending on what you need, you may take one on its own or with other types of RA drugs.

Side effects: Because they slow down the immune system, biologics make it harder for your body to fight infection. They can cause flare-ups of some infections that aren't active, such as tuberculosis. Some people also have reactions at the IV or injection site.

More widespread IV reactions, which are usually mild, include chest pain, trouble breathing, and hives. Each drug has its own set of side effects that you should talk about with your doctor.


Examples: Corticosteroids are often just called “steroids." There are lots of them. Common ones include hydrocortisone, methylprednisolone, and prednisone.

What they do: Corticosteroids are strong inflammation fighters that can quickly improve symptoms and ease swelling. They are less effective at slowing RA itself. Your doctor may prescribe them to get inflammation under control, or when you have a flare. For some people, a very low dose of steroids plus DMARDs or biologics controls their RA.

How you take them: You can take some by mouth. Others you get as a shot.

Side effects: Steroids can cause weight gain and bone loss, making osteoporosis more likely. They also may worsen diabetes and raise the risk of infections. Generally, lower doses taken for a shorter time means fewer side effects.


Examples: celecoxib (Celebrex), ibuprofen (such as Advil or Motrin), or naproxen (Aleve)

What they do: Lower inflammation and help relieve pain. They don’t slow joint damage.

How you take them: Many NSAIDs come as pills or tablets. Some need a doctor’s prescription. Others are sold “over the counter,” which means they don’t need a prescription.

Side effects: NSAIDs can cause stomach problems, including bleeding. They also have been linked to a greater risk of heart disease and stroke, especially in higher doses. NSAIDs should be used with caution in people who already have heart, liver, or kidney disease.