The catch: You have to take the medication exactly as prescribed — something that anywhere from 30 to 80 percent of people with RA do, according to a study published in April 2015 in BioMed Research International. If you’re not following your prescribed treatment plan, it can lead to flares and cause joint damage to accumulate, says Dr. Worthing. “Once the damage is done, it’s not likely to be repaired.” Plus, if you miss multiple doses before restarting your medication, you may discover that you’ve become immune to the drug. Bottom line: Don’t let anything stand in your way of following your treatment regimen — including these common excuses and habits.
1. You forget.
When you’re busy, it’s easy to forget to take your medication. One solution: Work your treatment regimen into routine parts of your schedule, like when you brush your teeth or pay your monthly bills, says Worthing. You can also set a reminder on your smartphone or write it down in your daily planner. The Arthritis Foundation also recommends using pill organizers, setting alarms, or sending yourself text messages.
2. You have trouble getting refills.
Some medications require monitoring and won’t be refilled unless you see your doctor or get your bloodwork done first. Be sure to request your refill at least a few days before you actually need it, says Elaine Husni, MD, MPH, vice chair of rheumatology and director of the Arthritis and Musculoskeletal Center at the Cleveland Clinic. Mark your calendar for when you will need to reorder your prescription. You can also ask for a 90-day supply to cut back on how often you need to request a refill. And if your pharmacy offers automatic refills, be sure to sign up.
3. Your medications are costly.
If you’re prescribed an expensive medication, apply for patient assistance programs (find a list here), which are supported by many pharmaceutical companies. You can also ask your doctor if you can switch to a cheaper medication or opt for a generic version instead. If this sounds familiar, be sure to talk to your doctor. “Some medications can be taken less frequently at higher doses,” says Worthing. Also work with your doctor and pharmacist to streamline your medication schedule as much as possible. The Arthritis Foundation also recommends getting all of your prescriptions filled at one pharmacy to avoid potential errors or drug interactions.
5. Your medication has unpleasant side effects.
Adjusting the dosage of your medication can often reduce side effects, says Worthing. In some cases, your rheumatologist can find another medication in the same class of drugs that you can try instead, he adds. “Many side effects such as fatigue can be managed by taking the medication at different times of day,” explains Dr. Husni. If that’s the case, she adds, “try taking your medication closer to bedtime or after dinner.” You also may just need to give it a chance, says Worthing. “Your body may adapt to the medication over time.” Whatever you and your doctor decide, it’s important to keep a log of which side effects you’re experiencing and bring it to your next checkup. That way you can discuss it all with your doctor and determine if what you’re experiencing is related to your medication or from other issues, says Husni. In some cases, what appears to be treatment side effects may actually be symptoms of another condition or a related illness that needs attention, adds Worthing.
6. You’re feeling anxious about your medication.
It can be overwhelming to have to take medication regularly in order to feel well. The idea of possible treatment side effects can also be scary. It helps to have an open discussion with your doctor about what medication they’re recommending and why. Your rheumatologist can give you the big picture and explain the risks and benefits of a particular medication, says Worthing. If you have anxiety, seeking treatment for your anxiety can help ensure it doesn’t get in the way of getting the best RA care possible, Worthing adds.
7. You have a negative image of yourself because you need medication.
Focus on your hopes for improvement. “There’s a reason for taking your medication — think of how it’s working to help relieve your symptoms,” says Worthing. Remind yourself that it’s okay if you need treatment to feel well and stay on top of your health.
8. You’re feeling great and think you no longer need treatment.
“We are learning throughout recent years that some people can reduce their dosage without their RA coming back,” says Worthing, though more research is needed to determine which individuals may have the best chance of doing well with less medication. In the meantime, you and your rheumatologist may decide to slowly cut back on a particular treatment, even though current guidelines recommend against reducing or stopping medication, adds Worthing. “In general, we want our patients in deeper remission — meaning little or no disease flare over many years,” notes Husni. Regardless, emphasizes Worthing, always talk to your doctor before making any changes in your medication regimen.
