Medications for Osteoarthritis

Here are the basics about each of the medicines below. Only common problems with them are listed.

Prescription Medications

Nonsteroidal Anti-inflammatory drugs (NSAIDs)

  • Naproxen
  • Ketoprofen
  • Ibuprofen
  • Indomethacin
  • Sulindac
  • Meclofenamate
  • Ketorolac
  • Piroxicam
  • Diclofenac

Cyclooxgenase-2 or COX-2 Inhibitors

  • Celecoxib
  • Meloxicam

Opioids

  • Hydrocodone
  • Oxycodone
  • Morphine
  • Hydromorphone
  • Fentanyl
  • Methadone

Antidepressants

  • Duloxetine

Over the Counter Medications

Acetaminophen

Capsaicin cream

Prescription Medications

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

  • Naproxen
  • Ketoprofen
  • Ibuprofen
  • Indomethacin
  • Sulindac
  • Meclofenamate
  • Ketorolac
  • Piroxicam
  • Diclofenac

NSAIDs help to ease inflammation and joint pain. Many are available without a prescription. Some may also be available as creams or patches. They can be placed on skin over the area.

Some problems may be:

  • Stomach upset
  • Stomach ulcers and bleeding
  • Worsening of some health problems, such as high blood pressure, heart failure, or kidney disease
  • Kidney damage
  • Liver inflammation
  • Lightheadedness
  • Severe allergic reaction, such as hives, problems breathing, or swelling around the eyes

Always take NSAIDs with food. This will lower the risk of stomach upset. Do not drink alcohol while taking NSAIDs. It causes extra stress on the liver.

NSAIDs are a common ingredient in many over the counter medicines. Read the ingredient list on labels. Do not take other medicines that contain NSAID ingredients.

NSAIDs may raise the risk of serious problems, such as heart attack and stroke. This risk is important for those who already have heart disease or risk factors like high blood pressure.

Cyclooxygenase-2 or COX-2 Inhibitors

  • Celecoxib
  • Meloxicam

COX-2 inhibitors work like NSAIDs. They help ease inflammation and joint pain. They cause less stomach irritation than NSAIDs.

Drinking alcohol or taking NSAIDs while using a COX-2 inhibitor can raise the risk of side effects.

Problems may be:

  • Stomach problems, such as stomach upset and ulcers
  • Kidney damage
  • Liver inflammation
  • Severe allergic reaction, such as hives, problems breathing, or swelling around the eyes
  • Worsening of chronic conditions, such as high blood pressure, heart failure, or kidney disease

COX-2 inhibitors may raise the risk of serious problems, such as heart attack and stroke. This risk is important for those who already have heart disease or risk factors like high blood pressure.

Opioids

  • Hydrocodone
  • Oxycodone
  • Morphine
  • Hydromorphone
  • Fentanyl
  • Methadone

Opioids may be given to ease severe pain. However, they may cause dependence. Monitoring will be needed while on this medicine.

Some opioids may have acetaminophen. This is also a common ingredient in many over the counter medicines. High doses of it can harm the liver. Read the ingredient list on labels. Do not take other medicines that contain acetaminophen.

Problems may be:

  • Lightheadedness
  • Tiredness
  • Blurred vision
  • Changes in thinking
  • Nausea or vomiting
  • Constipation
  • Itching
  • Dry mouth

Antidepressants

Antidepressants may help ease chronic pain caused by OA.

Common name: Duloxetine

Problems may be:

  • Lightheadedness
  • Sleepiness
  • Problems thinking clearly
  • Feeling nervous or excited
  • Blurred vision
  • Dry mouth
  • Headache
  • Nausea and vomiting
  • Diarrhea
  • Insomnia
  • Change in sexual ability or desire

This type of medicine can cause severe symptoms if it is stopped too fast. It should only be stopped under the advice of a doctor.

Over-the-Counter Medications

Acetaminophen

Acetaminophen can help ease pain from OA. It should be the first medicine option in most people with OA.

This medicine can harm the liver. Do not take a larger dose than advised. Do not drink alcohol when taking it every day.

Side effects are rare. A few people may have an allergic reaction, such as rash, swelling, or problems breathing.

Capsaicin Cream

Common brand names are:

  • Zostrix

Capsaicin cream is rubbed on the skin of a joint to ease pain and inflammation.

It is made from the active part of hot chile peppers. Wear rubber gloves when putting it on or practice proper hand washing after it is used. Do not get the cream near the eyes. It will burn and sting.

There may be burning, stinging, or a warm feeling when first putting it on.

References:

Derry S, Moore RA, et al. Topical NSAIDs for acute musculoskeletal pain in adults. Cochrane Database Syst Rev. 2015;2015(6):CD007402. Published 2015 Jun 11. doi:10.1002/14651858.CD007402.pub3.
Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.niams.nih.gov/health-topics/osteoarthritis. Accessed August 24, 2021.
Osteoarthritis (OA) of the hip. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/osteoarthritis-oa-of-the-hip. Accessed August 24, 2021.
Osteoarthritis (OA) of the knee. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/osteoarthritis-oa-of-the-knee. Accessed August 24, 2021.
Last reviewed July 2021 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT
Last Updated: 8/24/2021

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