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Most young people with JIA are treated first with non-steroidal anti-inflammatory drugs (NSAIDs). These are called first-line medications because they are usually the first type of medication a doctor will use to treat JIA. These medications do not contain steroids.
How do NSAIDs work?
As you learned in the first section, JIA is joint inflammation. NSAIDs decrease the chemicals that cause inflammation and help to reduce pain, swelling, and stiffness in your joints. These drugs can help you to participate in normal day-to-day activities. It might take between eight to 12 weeks to see improvement.
Types of NSAIDs
There are several different NSAIDs used to treat JIA. The choice of medication is based on the type of JIA you have, how easy it is to take, and which drug your doctor thinks is best for you. Sometimes one NSAID might work while another might not. You may need to try several NSAIDs to find which one works best for you.
The following are NSAIDs commonly used to treat JIA.
| NSAID generic name | Most common brand name | How it is given | How the medication comes | Side effects |
|---|---|---|---|---|
| Naproxen | Naprosyn | By mouth, twice daily | Liquid or pill | Common side effects:
Less common side effects:
|
| Ibuprofen | Advil; Nurofen | By mouth, three to four times daily | Liquid or pill | |
| Indomethacin | Indocid | By mouth, three times daily | Liquid or pill | |
| Diclofenac sodium | Voltaren | By mouth, up to three times daily | Pill | |
| Piroxicam | Feldene | By mouth, once daily | Pill | |
| Celecoxib | Celebrex | By mouth, twice daily | Pill | |
| Meloxicam | Mobic | By mouth, once daily | Pill |
Important safety points about taking NSAIDs
• NSAIDs should always be taken with food. This can make it easier on your stomach.
• One rare side effect of NSAIDs is stomach ulcers. If you develop persistent stomach upset with your NSAID medication, talk to your doctor. He or she may prescribe a drug to help protect your stomach from developing ulcers. Signs of an ulcer may include vomiting blood or passing a bloody or black stool. If this occurs, you should stop your NSAIDs and see your doctor immediately.
• Your doctor may order blood and urine tests when you come to the clinic to make sure that your medication is not causing any problems in your body that you might not feel.
• If you need to take another medication for pain or fever, take acetaminophen (Tylenol). DO NOT TAKE another NSAID (like ibuprofen: Motrin or Advil) because then you would be taking too much anti-inflammatory medication, leading to more side effects.
Tips for managing side effects of NSAIDs
Take your NSAIDs with food. For example, try to pair taking your pills with breakfast, lunch, or dinner. If you need to take your medications at school, try to carry a small snack with you.
Some NSAIDs may make you sun sensitive. Use adequate sun protection, like sunscreen, while taking NSAIDs, especially if you are fair-skinned.