Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Unless there is some reason not to use aspirin, such as an allergy, this medication is usually the first treatment attempted for RA. Aspirin is effective in reducing inflammation and is less expensive than the other NSAIDs. The dosage depends on a balance between the large amounts of aspirin that may be needed to control symptoms and the development of side effects.

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Other NSAIDs are employed when aspirin is ineffective or causes serious side effects. These drugs are more expensive than aspirin, but compliance may be better because they are taken fewer times each day.

Some (not all) studies suggest that COX-2 inhibitors have fewer gastrointestinal side effects than other NSAIDs. But in light of the recent concerns about COX-2 inhibitors and cardiovascular problems, consult your doctor if you're taking a COX-2 inhibitor.

The goal is to use the NSAID that provides the greatest benefit while producing the fewest side effects; some trial and error may be needed because some people respond better to one drug than another.