Pain Relievers (Analgesics)

Analgesics are a type of medicine used to relieve pain and inflammation caused by rheumatoid arthritis (RA). Typically, analgesics will be recommended during flare-ups, and they are usually used as a short-term method of pain relief.^1,2

Analgesics may also be recommended for people with RA who cannot tolerate the side effects of non-steroidal anti-inflammatory drugs (NSAIDs). One type of commonly used analgesic is acetaminophen (Tylenol^®), which is available without a prescription.^1,2

Other types of analgesics are known as narcotic analgesics or opioids. Opioids are available by prescription only. Some opioids are combined with acetaminophen for additional pain relief.¹

Analgesics can be highly effective at reducing pain during a flare-up in RA. However, they do not stop disease progression, so they are not used alone to treat RA.²

How do analgesics work?

When you experience pain, it is because the nerve endings in your body send signals to the brain which causes the pain sensation. Analgesics work by blocking that signal between the nerve endings and the brain, therefore reducing the pain sensation.²

Opioids work by attaching themselves to receptors in your brain cells, which change the signals released to your brain, diminishing the pain sensation. Opioids also boost pleasure sensations, which can make them highly addictive.³

Analgesics start to work quickly on pain, often taking effect within 30 minutes of taking the medicine. It is important to follow your doctor’s directions when taking prescription analgesics, particularly opioids, and take them exactly as prescribed.^2,3

Examples

Common analgesics include:²

• Acetaminophen (brand name Tylenol^®)
• Tramadol (brand name Ultram^®)
• Codeine
• Hydrocodone ER (brand names include Hysingla ER^® and Zohydro ER^®)
• Oxycodone ER (brand name OxyContin^®)
• Hydrocodone/acetaminophen combination (brand names include Lorcet^®, Lortab^®, Norco^®, and Vicodin^®)
• Meperidine (brand name Demerol^®)
• Methadone (brand names include Dolophine^® and Methadose^®)

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking.

Common side effects of analgesics include:^1,2

• Dizziness
• Nausea
• Headaches
• Kidney problems
• Fluid retention and swelling

At low doses, opioids can cause drowsiness and constipation. Higher doses may slow your breathing and heart rate, which could lead to death. The increased pleasure sensation that accompanies opioids can also lead to addiction.^2,3

These are not all the possible side effects of analgesics. Talk to your doctor about what to expect when taking analgesics. You also should call your doctor if you have any changes that concern you when taking analgesics.

Other things to know

Analgesics, especially opioids, can interact negatively with other medicines, so always notify your doctor about all the medications you are taking.^2,4

Some drugs that may interfere with opioids include:⁴

• Alcohol
• Anti-seizure medications
• Certain antibiotics
• Certain antidepressants
• Certain antifungals
• Certain antiretroviral drugs (used for HIV infection)
• Sleeping pills
• Certain psychiatric disorder medications
• Muscle relaxers
• Sedatives
• Other opioids

Mixing these medicines with opioids may increase the likelihood of dangerous side effects, such as slowed breathing and decreased heart rate. Signs of an emergency that should not be ignored include:⁴

• Very small pupils that remain the same size when light is shined into them
• Losing consciousness
• Very slow breathing
• Blue or purple lips and/or fingernails

Seek emergency care right away if these symptoms occur.⁴

Before beginning treatment for RA, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.