Suffering from more than one medical condition often means that a patient is required to take a cocktail of drugs to treat all of their symptoms. For a patient suffering with arthritis in addition to another medical condition, getting the right mix of multiple medications is essential. 

Finding the right mix

When a patient is given an anti-inflammatory drug to treat arthritis, there needs to be an immediate focus on the risk of gastrointestinal bleeds. There are many factors which can contribute to an increased risk of bleeds, including if the patient is currently taking a blood thinning drug, like aspirin,  to treat another condition.

A scenario like this could then necessitate the introduction of an additional drug to protect and decrease acidity in the stomach. “But when you create a lower acidity in the stomach, certain nutrients may not be as well absorbed,” says Carolyn Whiskin, Pharmacy Program Director at the Charlton Centre For Specialized Treatments. “In a low acid environment, a patient’s B12, magnesium, and iron levels could be lowered.” 

Acetaminophen is an effective drug used to treat osteoarthritis. When it’s used in conjunction with both over the counter and prescription medications, it’s unlikely to interact in a harmful way. “It has great potential benefit and, compared with traditional anti-inflammatory medications, the risk of bleeding, increased blood pressure, and fluid retention is minimized,” says Whiskin. “In hospitals it’s often the pain killer of choice because it has the least amount of interactions to worry about.”  

Living with multiple conditions

Stephanie Leblanc was aged 20, enjoying university life, time with family and friends, and being active when she first started experiencing sore and swollen feet. Initially, she was told by her doctor to wear more appropriate footwear but after a blood test, her rheumatoid factor was found to be off the chart. She was diagnosed with rheumatoid arthritis and her symptoms began to worsen.

“It wasn’t until I was 27 that the biologic treatments came on the market,” says Stephanie. “I tried one and it completely changed my lifestyle. I was able to go back to being active and to having a relatively normal existence.”

Then, three years ago, at the age of 37, when she and her husband were trying to start a family, Stephanie was diagnosed with thyroid cancer and had to undergo a thyroidectomy. She now takes a daily thyroid replacement medication as well as her arthritis drugs.

Get educated to get healthy

“There have been times when my arthritis drugs have interacted with my thyroid replacement,” says Stephanie. This was particularly the case following the birth of her twin babies. She experienced a severe flare up of her rheumatoid arthritis and her thyroid was unstable with the change in hormones. “A very important side effect was the interaction with my thyroid and metabolism,” says Stephanie. “Doctors had to play around with my medication and dosage to find the right mix.”

 Stephanie is feeling happy and healthy on her current mix of medications and her goal is to get stabilized and minimize any joint damage as a result of her rheumatoid arthritis.

She advises arthritis suffers who take medications for multiple conditions to be proactive in seeking out the opinions of doctors and pharmacists. “Rely on the experts who serve you but also remember to be clear about all medications you are taking,” Stephanie says. “Patients need to take responsibility for their own health care, too.”

Whiskin echoes Stephanie’s feelings about the importance of patients interacting with doctors and pharmacists. To maximize their chances of remaining safe and healthy, arthritis patients taking multiple medications need to engage in an open and ongoing dialogue. 

“A sit down assessment in which you look at the entirety of your medication profile has a lot of value,” says Whiskin. “Patients need to understand their medications and how they might interact with each other.”