Despite the use of medications to treat joint damage progression in people with rheumatoid arthritis (RA), there are times when pain relievers are needed to lessen the pain. Opioid pain relievers (e.g., morphine) usually work by acting on pain receptors in the nervous system to change the perception of pain as well as the emotional response to pain.
Pain relievers used for RA include:
- acetaminophen (Tylenol®, generics)
- codeine with or without acetaminophen (Tylenol with Codeine®, Codeine Contin®, generics)
- oxycodone with acetaminophen (Percocet® and generics)
- tramadol with or without acetaminophen (Tramacet®, Zytram XL®)
- What does it do? Acetaminophen relieves pain but not swelling and is believed to work by increasing your pain tolerance.
- How do I use it? Acetaminophen is an oral medication (taken by mouth) and is usually taken every 4 to 6 hours as needed. Some types of acetaminophen are taken every 8 hours.
- What are some known side effects? Acetaminophen is generally well tolerated. Serious side effects (including liver damage) can occur when more than the recommended dose of acetaminophen is taken. Drowsiness, dizziness, shortness of breath, nausea, and vomiting are common side effects of medications that contain both acetaminophen and codeine (an opioid - see below).
- What does it do? Opioids relieve all pain severities, from mild to moderate to severe. They work by acting at pain receptors to block the pain sensation.
- How do I use it? Opioids are usually taken orally and the dose depends on the individual. They are usually taken every 4 to 12 hours, depending on the type of opioid medication.
- What are some known side effects? Opioids can cause drowsiness, nausea, vomiting, dizziness, lightheadedness, sweating, constipation, and euphoria (feeling of well-being). Serious side effects are breathing problems, including shortness of breath or shallow breaths - especially when more than the recommended amount is taken. There is also the risk of dependence and potential abuse with opioids. Drug abuse is usually not a problem for people who are taking opioids for pain as recommended by their doctor. Dependence on the medication can occur, so people who have been taking opioids should not suddenly stop taking the medication; their doctor will gradually decrease the dose.
- What does it do? The way tramadol relieves pain is not exactly clear but it is believed to act at pain receptors.
- How do I use it? Tramadol is taken orally and the dose depends on the individual. They are usually taken either once a day or every 4 to 6 hours, depending on the specific medication.
- What are some known side effects? Tramadol can cause drowsiness, nausea, vomiting, constipation, headache, dizziness, and loss of appetite. Serious side effects associated with tramadol include seizure and dependency.
You and your doctor can determine which medication is appropriate for you. Talk to your doctor for more information on treating RA with pain relievers.