As the owner of a fencing company in Toronto, Cathy Hofstetter organizes numerous employees and tasks so the business runs smoothly. This practice also applies beyond her office, to her health. For Hofstetter, managing her multiple medications — knowing which can be taken together — is crucial to her well-being.

Hofstetter has osteoarthritis, one of the most common forms of arthritis and a leading cause of disability in Canada, according to the The Arthritis Society. Osteoarthritis occurs when the cartilage between the joints slowly wears away causing stiffness and pain.

Though the average age of diagnosis is 50, Hofstetter first realized something was wrong at the age of 36 years old, when she experienced extreme pain in her left foot.

“I was due to leave to go and work at a trade show in Europe and I couldn’t get a shoe on my foot,” she says. X-rays revealed that not only did she have osteoarthritis but also rheumatoid arthritis.

Now 59-year-old Hofstetter has osteoarthritis in her spine, left thumb, and feet.

“When I get up in the morning, my back is really stiff and I have trouble bending over to put shoes on or anything like that,” she says. She adds that the joints in her hand also get stiff, making simple tasks like sipping a full cup of coffee a challenge. 

But for Hofstetter, dealing with osteoarthritis meant more than just managing the pain. Since she also lives with rheumatoid arthritis, high blood pressure and migraines, the business owner has had to learn how to safely manage multiple medications. 

Find the right mix

Physicians often recommend pain relievers — either anti-inflammatories, such as ibuprofen, or acetaminophen — to help osteoarthritis patients manage their symptoms.

While both can help to effectively relieve the pain associated with osteoarthritis, it is important to consider what other medications the individual might be taking.

“Although elderly patients can sometimes be safely prescribed anti-inflammatories or other medications, you have to be very careful about potential adverse effects,” says Dr. Sol Stern, Hofstetter’s physician.

For instance, patients are advised not to use certain anti-inflammatories (e.g. ibuprofen) if they are taking daily low-dose ASA (81-325 mg) without first talking to a doctor or pharmacist since ibuprofen can interfere with the preventative benefits of ASA.

Experts say for patients on numerous medications, acetaminophen may be an appropriate pain relief option.

Get informed

While acetaminophen cannot slow down the progression of osteoarthritis, Stern says that it can make a difference for patients’ quality of life.

“A lot of people can cope better with arthritis if they use medication responsibly,” he says.

Stern emphasizes that patients should always speak with a health care professional before taking a new medication. 

“It’s really important for patients with arthritis who are going to buy something over-the-counter to speak with their pharmacist to go over all the medications they’re on,” he says. “The pharmacist can give them a lot of insight on potential drug interactions.”

Twenty-three years after she was diagnosed with osteoarthritis, Hoffstetter is maintaining her health and still able to lead her company.

She says when it comes to safely managing multiple medications, it’s crucial to be informed about what you’re taking and why.

“The most important thing you can do is become knowledgeable about your disease and about the treatments for it because the two go hand in hand,” she says. “If you want to have a good outcome, it’s important that you learn about it.”