How to Know When to Change Medications

It’s a tricky art to figure out when to change medications for rheumatoid arthritis. To be honest, I have probably leaned too conservatively toward not changing quickly enough when a drug has stopped working for me. I’ve always given too much time between changes because I want to really be certain.

While some folks change more quickly and have tried more drugs, I’m not convinced that fast is the best answer either. Rather, I think we need to aim for a calculated middle point.

Switching RA medications

From my experience, there are a number of factors that patients need to weigh when considering their treatment options and when to make a change. It isn’t just, “this isn’t working” but requires digging a little deeper to make the best decision.

Consider the context

Reflecting on if the current treatment is working for you may be the first start, what gets you questioning in the first place about whether to change. But it’s also important to consider your health and life. For example, have you had more flares or stress in your life? What else could be influencing the drug’s effect on your rheumatoid arthritis?

Understand your personal treatment goals

One of the things I always think about with treatment is that my goals are somewhat different than other folks with RA.

I already live with a lot of joint damage and disabilities, so while further disease damage prevention is important it is not my top goal. When I consider treatment, I’m more focused on reducing fatigue, stiffness, and pain. Each patient has to think about what they are working toward, what they want from treatment and if the drug is helping (or not) and what other options may target their personal goals.

Weigh the side effects

A very important consideration is side effects. A drug may be working very well, but the side effects could be difficult to live with. This must be addressed as an important part of the picture.

The drug I just switched from didn’t help with my RA symptoms and also had challenging side effects on my body (headaches and stomach problems) so it really was negative all around. Sometimes I can live with uncomfortable side effects, but only if I feel the benefits to my RA outweigh these problems.

Compare the drug to previous ones (if you have previous experience)

I personally think the impact of a drug can be unique from person to person. So, when I am considering treatment options I also think about each previous treatment and how it felt. It’s not just how it helped (or didn’t) my RA symptoms, but my life on the drug and the impact of it.

For example, some drugs made me very sensitive to the sun. I adjusted with different habits like wearing hats and being careful about sun exposure. Other drugs were more difficult, such as increasing the number and severity of headaches. Sometimes our bodies can adjust, sometimes we can develop coping mechanisms. But it should all be remembered and weighed when we plan on making a medication change.

Trying a new RA medication

Unfortunately, we never know if a medication will work unless we try. And the drugs for treating RA often require a length of time before we feel an impact on our RA symptoms. Spending the time waiting while we struggle with our health is frustrating, but it cannot yet be avoided.

Making the best decision for yourself

While everyone has to make decisions about treatment that best suit them, I feel like I need to give a drug at least three to six months before I know the impact and can make a decision about staying the course or changing. There’s a lot to consider beyond just “is it working”.

What do others think about when weighing a medication change?