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Treating Rheumatoid Arthritis With Disease-Modifying Drugs (DMARDs)

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Are DMARDs Safe?

The FDA has approved all DMARDs. Many people take them without ever having problems.

But because they work throughout the body to fight RA, their powerful action typically does cause some side effects, commonly:

  • Stomach upset. DMARDs often cause nausea, sometimes with vomiting, or diarrhea. Other medicines can help treat these symptoms, or they often improve as you get used to the drug. If the symptoms are too uncomfortable to tolerate, your rheumatologist will try a different medication.
  • Liver problems. These are less common than stomach upset. Your doctor will check blood tests on a regular basis to make sure your liver is not being harmed.
  • Blood issues. DMARDs can affect the immune system and raise the risk of infection. Infection-fighting white blood cells may also be decreased. Low red blood cells (anemia) can make you tired more easily. A simple blood test by your doctor every so often will make sure your blood counts are high enough.

You should learn about possible side effects of any medicine you are taking and discuss them with your doctor until you feel comfortable.

To minimize side effects, DMARDs are sometimes started one at a time and increased gradually. The goal is to minimize both rheumatoid arthritis disease activity and medication side effects. Sometimes it takes more than one DMARD to get control of active rheumatoid arthritis. 

How do you know you're on the "right" regimen? There's no easy way. Rheumatologists use all their training and experience to determine what's right for you.

Though DMARDs can have side effects, there is a good reason to take them -- they're proven to work against rheumatoid arthritis. Even if you are in a remission, many rheumatologists believe you should keep taking a DMARD, just to keep your RA at bay.

WebMD Medical Reference

Reviewed by David Zelman, MD on June 10, 2013
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