Generic: azathioprine

Class: cytotoxic

Indication: Autoimmune conditions eg rheumatoid arthritis, rejection of transplanted organ

Dose: 50 - 150 mg daily

SIDE EFFECTS

common: leucopaenia, thrombocytopenia, anaemia, infection, alopecia, diarrhoea, anorexia, nausea and vomitting, mouth ulceration, oesophogitis

infrequent: hepatitis

rare: hepatic veno-occlusive disease, hypersensitivity syndrome

Generic: cyclosporin

Class: cytotoxic (calcinurin inhibitors)

Indication: autoimmune conditions eg rheumatoid arthritis, prevention of organ rejection in transplant

Dose: 2.5 - 15 mg / kg in 2 doses

SIDE EFFECTS

common: nephrotoxicity, hypertension, hypercholesterolemia, tremor, parasthesia, neurotoxicity including seizures, elevated liver transaminase, hypomagnaemia, hyperkalaemia, opportunistic infection, diarrhoea, hyperglycaemia, increased insulin requirements, diabetes, permanent renal changes

infrequent: headache, myopathy, muscle weakness

Generic: leflunomide

Class:

Indication: rheumatoid arthritis

Dose: 10 - 20mg daily

SIDE EFFECTS

common: abdominal pain, diarrhoea, nausea, vomitting, cholelithias, raised liver enzymes, hair loss, mild allergic reactions, itch, eczema, weight loss, weakness, synovitis, headache, dizziness, bronchitis, pharyngitis, dyspnoea, pneumonia, hypertension

infrequent:

rare:

Generic: allopurinol

Class: xanthine oxidase inhibitor

Indication: gout prophylaxis

Dose: 100 - 300mg d

SIDE EFFECTS:

common:

maculopapular or itchy rash

infrequent: nausea, vomitting, taste disturbances, diarrhoea, abdominal pain, headache, drowsiness, vertigo, athralgia

rare: hypersensitivity, hepatotoxicity, blood disorders

Generic: colchicine

Indication: acute gout

Dose: 1mg stat, then 500mcg q6h, max 6mg per course

SIDE EFFECTS

Common: diarrhoea, nausea, abdominal discomfort, vomitting

Infrequent: GI haemorrhage, rash

Rare: hypersensitivity, blood disorders, hepatitis, myopathy, alopecia

Generic: probenecid

Indication: gout prophylaxis, adjunct to penicillin treatment

Dose: 250mg - 500mg bd or qid

SIDE EFFECTS

common: rash, nausea, vomitting

infrequent: headache, dizziness, flushing, sore gums, alopecia, urinary frequency, uric acid kidney stones

rare: nephrotic syndrome, allergic reactions, hepatic necrosis, blood disorders

Generic: sulfasalazine

Class: anti-inflammatory

Indication: rheumatoid arthritis, Chrohn's disease

Dose: 500mg - 3g daily in divided doses

SIDE EFFECTS

Impairs folic acid absorption 

Common: nausea, rash, headache, diarrhoea, vomitting, haemolysis (not usually severe), reversible male infertility

Infrequent: yellow-orange discoloration of skin

rare: blood dyscrasias, hepatitis, pancreatitis 

Generic: penicillamine

Indication: rheumatoid arthritis, cystinuria

Dose: 125 - 1500mg in 2-3 divided doses

SIDE EFFECTS

common:

rash, stomatitis, taste disturbances, anorexia, nausea, vomitting

infrequent:

allergy, itching, urticaria, fever, proteinuria, oral ulceration

rare:

blood dyscrasias, hepatotoxicity

Generic: hydroxychloroquinine

Class: antiinflammatory

Indication: rheumatoid arthritis, erythmatous

Dose: 200 - 600mg daily (if more than 200mg, in divided doses)

SIDE EFFECTS:

common: nausea, diarrhoea, anorexia, rash, alopecia, abdominal cramps

infrequent: vomitting, vertigo, tinnitus, nerve deafness, headache, nervousness, muscle weakness, neuromyopathy

rare: retinopathy, corneal changes, hepatitis, photosensitivity

Generic: celecoxib

Class: Cox-2 inhibitor

Indication: rheumatoid arthritis, osteoarthritis, gout, period pain

Dose: 100 - 200mg once or twice daily

SIDE EFFECTS

common:

nausea, dyspepsia, GI ulceration or bleeding

Generic: auranofin

Class: gold salts

Indication: rheumatoid arthritis

Dose: 3 - 9mg in 1 -3 divided doses.

SIDE EFFECTS

common: diarrhoea, dyspepsia, stomatitis, nausea, vomitting, taste disturbances, rash, itching, alopecia, conjunctivitis, blood dyscrasias, nephrotoxicity

Generic: aruothiomalate

Class: gold salt

Indication: rheumatoid arthritis

Dose: 25 - 50mg every 4-6 weeks

SIDE EFFECTS:

common: diarrhoea, dyspepsia, stomatitis, nausea, vomitting, taste disturbances, rash, itching, alopecia, conjunctivitis, blood dyscrasias, nephrotoxicity

practice points:

sunlight can aggrevate gold-inducated dermatitis.

stop treatment if platelet count falls below a set amount

generic: diclofenac

class: NSAID

indication: arthritis (osteo, rheumatoid, gout), pain

dose: max 200mg daily in 2-3 divided doses

SIDE EFFECTS

common:

nausea, dyspepsia, GI ulceration, raised liver enzymes, diarrhoea, headache, dizziness, hypertension, salt and fluid retention

infrequent: oesophageal ulceration, heart failure, hyperkalaemia, renal failure, confusion, bronchospasm, rash

generic: ibuprofen

class: NSAID

indication: arthritis (all types), pain 

dose: max 2400mg daily in 3-4 divided doses

CLASS:

common: nausea, dyspepsia, GI ulceration, raised liver enyzmes, diarrhoea, headache, dizziness, salt and water retention

infrequent: oesophageal ulceration, heart failure, rash, hyperkalaemia, renal impairement, confusion, bronchospasm

Generic: indomethacin

Class: NSAID

Indication: arthritis (rheumatoid, osteo, gout), pain

Dose: 25 - 50mg qid

SIDE EFFECTS

common: nausea, dyspepsia, GI ulceration, diarrhoea, salt and fluid retention, headache, dizziness, hypertension

infrequent: oesophogeal ulceration, heart failure, renal failure, hyperkalaemia, rash, bronchospasm,

Generic: ketoprofen

Class: NSAID

Indication: arthritis (rheumatoid, osteo, gout), pain

Dose: 200mg daily

SIDE EFFECTS

common: nausea, dyspepsia, GI ulceration, diarrhoea, headache, salt and water retention, hypertension, dizziness

infrequent: oesophogeal ulceration, heart failure, renal failure, hyperkalaemia, rash, bronchospasm, confusion

Generic: ketorolac

Class: NSAID

Indication: arthritis (gout, rheumatoid, osteo), pain

Dose: 10mg q4-6h (max 40mg daily)

SIDE EFFECTS

common:

nausea, dyspepsia, GI ulceration, diarrhoea, dizziness, headache, salt and water retention, hypertension

infrequent:

oesophogeal ulceration, renal failure, heart failure, hyperkalaemia, confusion, bronchospasm, rash

Generic: mefenamic acid

Class: NSAID

Indication: arthritis (gout, rheumatoid, osteo), pain

Dose: 500mg tds

SIDE EFFECTS

common:

nausea, GI ulceration, dyspepsia, diarrhoea, headache, dizziness, salt and water retention, hypertension

infrequent:

oesophogeal ulceration, heart failure, renal failure, hyperkalaemia, confusion, rash, bronchospasm

generic: meloxicam

class: NSAID

indication: pain, arthritis (gout, osteo, rheumatoid)

Dose: 7.5 - 15 mg daily

SIDE EFFECTS

common:

nausea, dyspepsia, GI ulceration, diarrhoea, headache, dizziness, salt and water retention, hypertension

infrequent:

oesophageal ulceration, renal failure, heart failure, hyperkalaemia, confusion, rash, bronchospasm

generic: sulindec

class: NSAID

indication: pain, arthritis (gout, rheumatoid, osteo)

dose: 200 - 400mg 1 or 2 times daily

 SIDE EFFECTS

common: nausea, dyspepsia, GI ulceration, diarrhoea, headache, dizziness, salt and fluid retention, hypertension

infrequent: oesophageal ulceration, renal failure, heart failure, hyperkalaemia, confusion, bronchospasm, rash

generic: piroxicam

class: NSAID

dose: 10 - 20mg daily

indication: pain, arthritis (gout, rheumatoid, osteo)

SIDE EFFECTS

common: nausea, dyspepsia, GI ulceration or bleeding, diarrhoea, dizziness, headache, hypertension, salt and water retention

infrequent: confusion, renal failure, heart failure, rash, hyperkalaemia, oesphogeal ulceration, bronchospasm

generic: tiaprofenic acid

class: NSAID

dose: 300mg once or twice a day

indications: pain, arthritis (gout, osteo, rheumatoid)

SIDE EFFECTS

common: nausea, dyspepsia, GI ulceration, diarrhoea, dizziness, headache, hypertension, salt and fluid retention

infrequent: oesophogeal ulceration, heart failure, renal failure, hyperkalaemia, confusion, rash, bronchospasm