Best Ways to Manage RA Treatment Side Effects

Patient Expert
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Treating your RA involves taking a variety of medications which may have side effects. Not everyone experiences side effects, but if you do, you may not have the same side effects as another person or to the same degree. Side effects often lessen over time as your body gets used to the medication. Most side effects are often manageable.

Track your symptoms

If you are having unusual symptoms, using a symptom tracker app or symptom diary can help you identify patterns between your symptoms and their triggers. This can identify which of your symptoms are related to taking medications, which will help when you discuss the issues with your doctor. Knowing when side effects occur can also help you plan around them.

RA meds can be hard on the stomach

NSAIDs are known for being very hard on the stomach. They may cause acid reflux or GERD. They can also increase the risk of a GI bleed. You can still take them, but pay attention to side effects. Talk to your doctor if it feels as if there is a roiling vat of acid in your mid-region. They may want to prescribe a PPI medication to help or suggest over-the-counter remedies.

Natural remedies for acid reflux

Probiotics can be very helpful to ease symptoms of acid reflux. Other natural remedies that can help include tea and slippery elm in lozenges or tea. Eating almonds or drinking low-fat milk can help counteract the acid. You can also try a teaspoon of baking soda in a glass of water. Sleeping with your head elevated or on your left side may help avoid reflux at night.

Dealing with nausea

RA drugs such as methotrexate and the Biologics may make you queasy. Ginger and peppermint teas and candies can help, as can hot water with a small slice of lemon. Fresh vegetables and fruit can be easier to face than a rich, greasy meal. Crackers and toast with some applesauce can be palatable with high levels of nausea. If you have severe nausea and vomiting, talk to your doctor.


One of the easiest ways of dealing with constipation is to include more fiber in your diet. Eat whole grains and high-fiber cereals, fresh fruits and vegetables (unpeeled), and try hummus as a sandwich spread instead of mayo. Snack on trail mix and prunes (actually yummy) and drink lots of water. If it gets really bad, try prune juice, or stool softeners available over the counter.


If you have diarrhea, stay away from the high-fiber food for a few days. Focus on foods that are constipating, such as red meat, white rice, dairy, and eggs. If it’s really bad, use the BRAT diet: bananas, rice, applesauce, and toast. Over-the-counter remedies may also help slow or stop the diarrhea. If it is affecting your health and energy levels, talk to your doctor about changing medications.


If you are on an immunosuppressant, such as methotrexate or a biologic, it’s common to feel tired after you take it. Scheduling your medication before the weekend can give you a couple of days to rest. Be good to yourself, take naps, and watch movies. Preparing a freezer meal ahead of time can save you from cooking, and still get you a nutritious meal.

Infection risk

A common side effect of immunosuppressants is increased risk of infections. Try to avoid people who are sick, and carry a mask just in case. Make sure you get the flu, pneumonia, and tetanus vaccines. Avoid public surfaces that don’t get cleaned often, such as gas pump handles, ATM and elevator buttons, and handrails. Carry gloves and hand sanitizer. You can also use a key or pen to press buttons.

Rare and serious side effects

Like all medications, RA drugs have the potential for serious side effects. Many of these types of side effects can be reversible. Talk to your doctor about how to manage the risk, and which symptoms to look out for. Take them seriously and seek medical attention immediately if you experience them.

What to do when side effects are not manageable

Sometimes, side effects stop being manageable and begin to take over your life. When this happens, it’s a sign that you may want to talk to your doctor about changing medication. Keep in mind that RA meds are intended to help you get back to your life, not limit you as much as untreated RA would.