How Common Drugs Interfere With Arthritis Treatment

Make sure that pill you're popping isn't hindering your arthritis pain relief.

Health Monitor Staff
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Drugs interfere arthritis treatment

Following your arthritis-treatment plan to the letter but still not getting the relief you’re after? Take a peek in your medicine cabinet. Many everyday drugs and supplements taken for other conditions can interfere with your arthritis medications and even lead to problems that could have been avoided.

Check the table below for common interactions—the list is not comprehensive, so there could be others—and report any concerns to your healthcare provider or pharmacist. And remember, never stop taking a medication without consulting the healthcare provider who prescribed it.

Treatment: Acetaminophen (e.g., Tylenol)

What can interact with it:

  • Alcohol (three or more drinks a day)
  • Narcotic pain relievers (e.g., combination products with codeine)
  • Cold & flu remedies (e.g., combination products for fever and pain)

Potential problems:

  • Combining any of these increases the risk of acetaminophen poisoning and liver damage. Alert! Acetaminophen overdose is a common drug-related reason for ER visits. Be aware that several products contain it.

Treatment: Nonsteroidal anti-inflammatory drugs (NSAIDs), including prescription and OTC versions, such as aspirin, ibuprofen, naproxen, diclofenac and celecoxib (Never take two NSAIDs together, which can increase the risk of bleeding.)

What can interact with it:

  • Alcohol (three or more drinks a day)
  • Blood pressure meds
  • Blood thinners (e.g., warfarin) • Corticosteroids (e.g., prednisone)
  • Supplements (e.g., blood-thinning herbs such as ginkgo, garlic, ginger) 

Potential problems:

  • May increase risk of stomach bleeding.
  • Diuretics (water pills) may not be as effective when taken with NSAIDs.
  • Taking ibuprofen with ACE inhibitors (e.g., enalapril) can decrease effectiveness and lead to kidney damage.
  • Increased risk of stomach bleeding and ulcers, depending on dose and type used.

Treatment: Corticosteroids (e.g., prednisone)

What can interact with it:

  • Diabetes meds (including oral drugs and insulin)
  • Supplements (e.g., high-dose zinc or blood-thinning herbs such as ginkgo, garlic, ginger)

Potential problems:

  • May interfere with blood sugar control, since corticosteroids can raise blood sugar.
  • Certain herbs may increase the risk of stomach bleeding and ulcers.
  • Studies suggest high-dose zinc may block the action of corticosteroids, reducing their effectiveness.

Treatment: Disease-modifying antirheumatic drugs (DMARDs), which are used to treat rheumatoid arthritis, psoriatic arthritis and lupus. Examples include methotrexate,sulfasalazine and the drug class called biologics.

What can interact with it:

  • Blood thinners
  • Drugs that suppress the immune system (check with your doctor about the specific types you should avoid)
  • Echinacea and other immune-boosting supplements
  • Gout medicine such as allopurinol 

Potential problems:

  • Combining sulfasalazine with blood thinners increases the risk of bleeding.
  • Could increase the risk of infections, since DMARDs keep inflammatory diseases in check by suppressing parts of the immune system.
  • Could decrease the effectiveness of DMARDs and increase the risk of liver problems.
  • Combining allopurinol with certain DMARDs increases the risk of liver problems.

Treatment: Gout medications

What can interact with it:

  • Aspirin
  • Diuretics (water pills used to control blood pressure)

Potential problems: Although these drugs do not interfere directly with gout meds, aspirin and diuretics can trigger a gout flare, making it seem as if your gout treatment isn’t working.

Treatment: Osteoporosis medications

What can interact with it:

  • Antiseizure drugs (e.g., phenytoin, valproate)
  • Blood thinners (e.g., heparin)
  • Corticosteroids
  • Diuretics
  • Heartburn meds called proton pump inhibitors (e.g., omeprazole)

Potential problems: May interfere with osteoporosis treatment, since these meds can increase the risk of bone loss, depending on dose and length of time taken.

February 2014