If you have ankylosing spondylitis, you probably know how important it is to exercise along with the medication your doctor prescribes. These treatments can help reduce your pain and help you get through your day more easily. However, sometimes these medications can cause minor side effects. But don't worry, this is not the case for everyone. Everyone's body responds to medications differently. Therefore, it is important to find the right medication for you, with the fewest side effects. Today, we will talk about these medications and their possible side effects.
First-line medication: NSAIDs
These are the first painkillers that doctors usually prescribe for people with ankylosing spondylitis. These are called nonsteroidal anti-inflammatory drugs, or NSAIDs . You may be familiar with these names: Ibuprofen, Naproxen, Indomethacin, Celecoxib, etc. These are the drugs that fall into this category.
These mainly work by reducing inflammation and pain in your joints. However, these medications can cause some side effects when taken in high doses for a long time.
The important thing is that not everyone gets these side effects, and if you experience one or two of them, it's important to talk to your doctor about them.
| Side effect | Let's learn about this simply. |
|---|---|
| Heartburn | It can be caused by the thinning of the protective lining of the stomach. It feels like a burning sensation in the chest. |
| Gastric inflammation and ulcers | Continued use of this medication may cause inflammation or small ulcers in the stomach walls. |
| Bleeding | Very rarely, stomach ulcers can cause internal bleeding. |
| Heart disease risk | If you already have heart disease, this medication may slightly increase your risk of heart attack or stroke. It is important to inform your doctor about this. |
Modern drugs: Biologics (IL-17 and JAK Inhibitors)
If NSAIDs are difficult to control your symptoms, your doctor may next recommend a special class of medications called biologics. These work by targeting specific chemicals in the body that cause inflammation and stopping them from working.
IL-17 Inhibitors
Secukinumab (Cosentyx) and Ixekizumab (Taltz) are two of these types of drugs. They are given as injections. Although they are very effective, they can have some side effects.
- Inflammatory Bowel Disease (IBD): This medication may cause new onset of IBD in some people or worsen symptoms if you already have it.
- Infections: Because these medications have a small effect on the body's immune system, the risk of developing common infections (such as flu and colds) may be slightly increased.
- Cancer risk: Although laboratory tests have shown a risk of cancer when given to mice, there is still no clear evidence of the risk to humans. Don't be unnecessarily worried about this, your doctor will educate you on this.
JAK Inhibitors
Tofacitinib (Xeljanz) is a type of medication that can be taken as a pill. It also works by reducing inflammation. Some of the side effects associated with it include:
- Headache
- Diarrhea
- Fatigue
- Heart palpitations
- Small risk of liver damage
Rarely used medications
In some cases, other medications may be added to your treatment plan.
Steroid medications (Corticosteroids)
These are not usually prescribed for long-term treatment of ankylosing spondylitis. However, if the pain and swelling suddenly become too much, your doctor may give you a steroid injection into the swollen joint. Long-term use of these medications can cause many side effects. Therefore, they are used only on a short-term basis, when necessary. Some of the side effects are:
- Increased appetite and weight gain
- Facial swelling, acne
- Body hair growth
- Easy bruising
- Diabetes (diabetes) or worsening if present
- High blood pressure
- Cataracts or glaucoma conditions
- Osteoporosis
Other joint pain medications (Sulfasalazine and Methotrexate)
If, in addition to your back pain, you also have pain in other joints, such as your shoulders, arms, and legs, your doctor may recommend these medications.
Sulfasalazine (Azulfidine): This is a pill. Side effects are rare, but some people may experience fever, nausea, skin rash, and headache.
Methotrexate: This can be taken as a pill or as an injection. When taking this medication, your doctor may recommend taking the vitamin folic acid to reduce side effects. Side effects may include nausea, mouth sores, and fatigue.
What to do if side effects occur?
This is the most important part. If you experience any changes or discomfort in your body due to the medication you are taking, the first and best thing to do is to tell your doctor.
Never stop taking your medication or change the dosage on your own. Doing so may suddenly worsen your condition.
When you tell your doctor about this, he or she may:
- Reduce your dose of medication.
- Switch to another medicine that suits you.
- Give another additional medication to control the side effect.
For example, if you have a stomach ache from an NSAID, your doctor may prescribe another medicine that protects your stomach at the same time. So, don't be afraid to talk to your doctor about all of this openly. Together, you and your doctor can find the treatment plan that works best for you and has the fewest side effects.
Take-Home Message
- Ankylosing spondylitis medications can cause side effects, but they don't happen to everyone. So don't be unnecessarily afraid.
- If you develop any new symptoms or discomfort due to the medication you are taking, inform your doctor immediately.
- Do not stop taking medication or change the dosage for any reason without consulting your doctor.
- Finding the medication that works best for you and has the fewest side effects is a journey you and your doctor will take together. It can take some time.
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