The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your healthcare provider if you need to take any special precautions. Use each of these medications as recommended by your healthcare provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your healthcare provider.

There are a variety of medications available to treat the pain and inflammation of osteoarthritis. You may have to try different medicines before you find the one that works best for you, with the least number of side effects.

Prescription Medications

Nonsteroidal Anti-inflammatory drugs (NSAIDs)

  • Naproxen (Naprosyn, Anaprox, Aleve)
  • Ketoprofen (Orudis)
  • Ibuprofen (Motrin, Advil, Nuprin)
  • Indomethacin (Indocin)
  • Sulindac (Clinoril)
  • Meclofenamate (Meclomen)
  • Ketorolac (Toradol)
  • Piroxicam (Feldene)
  • Diclofenac sodium (Voltaren)
  • Diclofenac (Voltaren, Cataflam)

Cyclooxgenase-2 or COX-2 Inhibitors

  • Celecoxib (Celebrex)
  • Meloxicam (Mobic)

***Please Note: On September 30, 2004, Merck & Co., Inc. announced a voluntary withdrawal of Vioxx® (rofecoxib) from the US and worldwide market due to safety concerns. A recent study showed a small but significant increased risk of cardiovascular events (such as heart attack) in patients taking the prescription medication. Vioxx® is a so-called "selective" non-steroidal anti-inflammatory drug (NSAID) specially designed to lower the risk of stomach irritation. It is commonly used in the treatment of acute and chronic pain associated with arthritis, menstruation, and other conditions. Since Merck's withdrawal of Vioxx®, evidence has come to light regarding similar dangers posed by the other popular selective NSAID, Celebrex® (celecoxib), which is produced by Pfizer. Most physicians now question the wisdom of prescribing any medications from the COX-2 class.

Over-the-Counter Medications

Acetaminophen (Tylenol)

Capsaicin cream (Zostrix)

Prescription Medications

Nonsteroidal Anti-inflammatory Agents (NSAIDs)

  • Naproxen (Naprosyn, Anaprox, Aleve)
  • Ketoprofen (Orudis)
  • Ibuprofen (Motrin, Advil, Nuprin)
  • Indomethacin (Indocin)
  • Sulindac (Clinoril)
  • Meclofenamate (Meclomen)
  • Ketorolac (Toradol)
  • Piroxicam (Feldene)
  • Diclofenac sodium (Voltaren, Cataflam)

Although many NSAIDs are available as over-the-counter medications, you may be given a prescription for a higher dose. Nonsteroidal anti-inflammatory agents help decrease inflammation, swelling, and joint pain.

Always take NSAIDs with food to decrease the chance of stomach irritation.

Drinking alcoholic beverages or taking other NSAIDs while you’re already using an NSAID can increase your risk of side effects.

Possible side effects include:

  • Stomach upset
  • Stomach ulcers
  • Kidney damage
  • Liver inflammation
  • Confusion, dizziness, lightheadedness
  • Severe allergic reaction (hives, difficulty breathing, swelling around the eyes)
  • Increased risk of bleeding – Always inform your healthcare providers that you’re taking a NSAID before having any medical or dental procedures or surgeries.

Cyclooxygenase-2 or COX-2 Inhibitors

  • Celecoxib (Celebrex)
  • Meloxicam (Mobic)

COX-2 inhibitors work in a way similar to NSAIDs, helping to decrease inflammation, swelling, and joint pain. In addition, they have the benefit of causing less stomach irritation. In particular, COX-2 inhibitors cause far fewer stomach ulcers than do NSAIDs.

Drinking alcoholic beverages or taking NSAIDs while you’re using a COX-2 inhibitor can increase your risk of side effects.

Possible side effects include:

  • Liver inflammation
  • Confusion
  • Severe allergic reaction (hives, difficulty breathing, swelling around the eyes)
  • Stomach upset

Over-the-Counter Medications

Acetaminophen

Common brand names include:

  • Tylenol

Acetaminophen can be helpful in relieving some of the pain associated with osteoarthritis. Do not take a larger dose than is recommended by your healthcare provider. Do not drink alcoholic beverages if you are taking acetaminophen on a daily basis.

Side effects are rare. A few people may experience an allergic reaction after taking the drug. If you develop a rash, swelling, or difficulty breathing, stop taking the acetaminophen and get medical attention.

Acetaminophen should be considered the first-line drug treatment in most osteoarthritis patients. In a recent study involving 41 patients with osteoarthritis in multiple joints severe enough to be treated with celecoxib, 80% were unable to distinguish between the effects of sustained-released paracetamol (acetaminophen) and celecoxib for overall symptom improvement. However, seven of the eight patients who could tell the difference found better relief with celecoxib. *

Capsaicin Cream

Common brand names include:

  • Zostrix

Capsaicin cream is a rubbed on the skin of an affected joint to relieve the pain and inflammation of osteoarthritis.

Capsaicin cream is made from the active ingredient of hot chile peppers. Some people prefer to wear rubber gloves while applying the cream. If you don’t, be sure to wash your hands thoroughly with soap and water after using the cream. Be very careful not to get the cream near your eyes, as it will burn and sting. If you do get some in your eyes, flush them thoroughly with cool water.

Possible side effects include:

  • Burning, stinging, or warm sensation when first applied to the skin.

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your healthcare provider.
  • Don’t share them with anyone else.
  • If you suspect you need to increase your medication for relief, consult your healthcare provider first
  • Know what effects and side effects to expect, and report them to your healthcare provider.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don’t run out.