Disease-modifying anti-rheumatic drugs (DMARDs) are used to treat rheumatic diseases. They aim to alter the disease by reducing pain, swelling, stiffness and joint damage over weeks and months. They include azathioprine, ciclosporin, gold, methotrexate, mycophenalate, leflunomide sulfasalazine, hydroxychloroquine and ciclosporin.
Some DMARDs are called ‘biologics’. They work by targeting individual proteins which are involved in rheumatic diseases. Biological agents include: abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, rituximab and tocilizumab. When started on a biologic, you should be given an alert card so that other healthcare professionals know what you are on.
The following content provides information regarding these common treatments used in rheumatic diseases. It does not replace advice given by a qualified medical professional (nurse, doctor or pharmacist). Some of these medications can be harmful before, during or even after pregnancy. It is therefore important to discuss contraception with your doctor, especially if you are pregnant, breastfeeding or are trying for a baby. Your rheumatologist will be able to discuss with you what medicines are appropriate during and after conception. Some medicines should also be avoided during breastfeeding and your rheumatologist will also be able to provide advice about this. If you are a man on one of these treatments, you should also talk to your rheumatologist before trying for a family.
With these medications it is safe to have the annual flu vaccine and it is recommended that patients taking medicines which may affect the immune system have their annual flu vaccine each year. Some medications on the following list may require you to have some additional vaccinations, please discuss this with a health professional. If you require a vaccination or are considering a long distance holiday where you need to be vaccinated in advance, please check with your rheumatologist if it is safe for the vaccine to be given to you. If you have any questions or doubts, please contact your doctor, nurse or pharmacist to discuss.
The following content also lists some of the side effects and interactions of the medications. More information can be found in the patient information leaflet that accompanies the medication. If you require more information, please refer to that leaflet. If there are any concerns or questions, please ask your rheumatologist, specialist nurse or pharmacist. It is important to let your doctor know what medications you are on before starting any new rheumatology drugs.
Please also let your doctor know if you start on any new medications whilst you are taking any of the drugs listed below.