DMARDs Disease-Modifying Anti-Rheumatic Drugs
DMARDs generally are effective, but they take time to show results – another reason to start them early. For example, hydroxychloroquine (Plaquenil) may take three or four months before you notice effects. Other drugs, such as methotrexate, work more quickly, but often not quickly enough if you're in pain now. For that reason, doctors often prescribe an additional drug – such as a corticosteroid or an NSAID – to help control pain and inflammation while the DMARD starts to work.
DMARDs are most commonly used for rheumatoid arthritis (RA), but some are also used for juvenile RA, ankylosing spondylitis, psoriatic arthritis and lupus. Some, such as chlorambucil (Leukeran) or cyclosphosphamide (Cytoxan) are used mainly to treat severe organ disease, such as the kidney disease caused by lupus or the vasculitis sometimes associated with RA. The dosages listed in this chart are for those with RA; depending on your specific condition and factors like disease severity, age, body weight and other medications you are taking, your dosage may vary.
Although DMARDs play an important role in arthritis treatment, only one – leflunomide (Arava) – was actually developed for RA. The others were borrowed from different areas of medicine. For instance, hydroxychloroquine (Plaquenil) is a malaria drug, chlorambucil (Leukeran) and methotrexate are cancer medications and cyclosporine (Neoral) originally was developed to keep the body from rejecting transplanted organs.
Because DMARDs suppress the immune system, always watch for signs of infection – chills, fever, sore throat or cough – and report them to your doctor. You should speak with your doctor before getting any vaccinations while you are taking these drugs.
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