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Oxford University Hospitals NHS Foundation Trust
OxPARC

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Medicines

Over the past decade there have been considerable advances in medicines and the way we use them in arthritis and other inflammatory conditions. These improvements have resulted in:

  • Better control of the inflammation that causes swelling, pain and stiffness
  • Reduced long term damage to joints and other organs

Care is taken in choosing the right medication. We will recommend a drug appropriate to the severity of inflammation, response to previous medicines and overall effect on quality of life.

To make sure the potential benefit outweighs the risk of side effects, we take into account the:

  • Joints or other organs involved
  • Amount of pain and stiffness
  • Patient's ability to walk, dress, write with a pen...

We discuss the choice of medicines with our patients and their parents, so that a joint decision can be made. We are also happy to discuss the medicines again at any time. If you are worried, we can be contacted via our advice line.

How are the medicines given?

The form of medicine given depends upon the:

  • Child's age
  • How the medicine is absorbed by the body (gut, skin, eye, joint, muscle, vein)
  • Desired speed of action
  • Whether the medicine works throughout the body (systemic), or only in a specific area (local)

Ways of giving a medicine include:

  • Liquid or syrup
  • Tablet
  • Injection into a joint
  • Injection under the skin
  • Injection into a muscle (buttock) or into the vein (infusion)
  • Drops into the eye

How often a medicine is given depends upon how long one dose acts for. This may vary from just a few hours to several weeks or months.

What are side effects?

Side effects are problems caused by a medicine.

We will discuss side effects when starting a medicine. It does not mean they will happen. Far from it. Naturally, we choose medicines that have the fewest and least severe side effects.

If a side effect does occur, it is usually minor. We closely monitor patients taking medicines with more serious side effects. This may involve a clinic visit and/or a blood test.

It is often true that the longer someone is on a medicine, the more likely they are to have side effects. We monitor these patients with a view to picking up any problems early. Action can then be taken quickly.

Sometimes it becomes apparent that a child or a teenager is unable to continue treatment. If this happens, we will provide help to cure the problem or give an alternative treatment.

How long does a medicine need to be continued for?

This depends on what we are to trying to achieve:

  • To provide symptom relief
    We sometimes prescribe medicine as a one-off. For example, steroids to control arthritis.
  • To fix a problem such as an infection or anaemia
    We may prescribe a short course of medication
  • To help whilst we wait for another medicine to work
    We may use another medicine as an interim measure
  • To maintain control of inflammation
    We may use a medicine for a longer period of time. Methotrexate is used in this way. Although all symptoms of arthritis may go, methotrexate is not stopped because it continues to suppress inflammation.