FDA Warnings and Recalls
Mainstream medications are the pharmaceuticals that are normally prescribed by rheumatologists for the treatment of scleroderma and other rheumatic diseases. These include DMARDs, immunosuppressants, NSAIDs, statins, and steriods. Which medication to use is dependented upon factors such as the patient, the symptoms, the doctors, and in some cases, the patient's insurance company (what is approved and what isn't). (Also see What is Scleroderma?, Types of Scleroderma, Medical Overview, Treatments and Clinical Trials, and Current Clinical Trials)
All of these mainstream medications can have serious side effects. Before using a drug, talk to your doctor and pharmacist about the potential side effects and any symptoms that may require immediate attention.
Also, provide a list of all medications to ensure that your new medication does not interfere or react with a medication you are already taking. You should always check for yourself by researching a new medication at drugs.com or rxlist.com.
Anesthesia and Systemic Sclerosis. Care should be taken to select the best anesthetic or analgesia for systemic sclerosis (scleroderma) patients, with consideration of their entire medical history plus general risk factors for scleroderma. ISN.
Avoid Steroids, Prednisone
Manage Cardiac and Vascular Issues
|Manage Gastrointestinal Issues
Biologics or biologic agents are biologic response modifying agents that block specific pathways and signals of inflammation. ISN.
|Overview of Biologic Agents
Etanercept (Enbrel, Benepali)
DMARDs are Disease-Modifying Anti-Rheumatic Drugs used for a variety of conditions from Irritable Bowel Disease to scleroderma. DMARDs include immunosuppressants, anti-malarial drugs, anti-inflammatory metals, and biologic agents. ISN.
|Overview of DMARDs
Antimalarials (Plaquenil, Hydroxychloroquine)
|Combination Therapy with DMARDs
FDA Warnings and Voluntary Recalls. Sometimes complications (especially rare ones) are acknowledged for medications only after they have been in widespread use. ISN.
Glucocorticoids are any of a group of steroid hormones, such as cortisone, that are produced by the adrenal cortex and have anti-inflammatory properties. Corticosteroids (such as prednisone) strongly increase the short-term risk of developing scleroderma renal crisis (kidney failure). (Also see What is Scleroderma?)
Use with Autoimmune Diseases
General Side Effects
Immunosuppressants are medications that suppress or prevent the immune response. Immunosuppressants are used to prevent rejection of a transplanted organ and to treat autoimmune diseases such as scleroderma, psoriasis, rheumatoid arthritis, and Crohn's disease. They are also referred to as immunodepressants.
Mycophenolate mofetil (Cellcept)
IVIg (Intravenous Immunoglobulin) is a blood product extracted from the plasma of about 20,000 blood donors. It contains the pooled human immunoglobulin Type G (IgG) which are antibodies of the immune system. IVIg is used to treat immune deficiencies and autoimmune and inflammtory diseases. ISN.
Intravenous Immunoglobulin (IVIG) May Be an Effective Therapy for Refractory, Active Diffuse Cutaneous Systemic Sclerosis (dcSSc). IVIG may be an effective adjunctive therapy for active dcSSc in patients failing other therapies. PubMed, J Rheumatol, 2015 Feb;42(2):236-42. (Also see Scleroderma Clinical Trials and IVIg)
NSAIDs (Nonsteroidal anti-inflammatory drugs) are normally used to treat inflammation and mild to moderate pain. The work by inhibiting Cox-1 or Cox-2 enzymes. Common anti-inflammatory drugs (aspirin, ibuprofen, and naproxen) act by blocking the action of both the COX-1 and COX-2 enzymes. COX-2 inhibitors (Celebrex) selectively block only COX-2. ISN.
|Overview of NSAIDs
NSAIDS and Cancer
|Possible Side Effects Cox-2 Inhibitors|
Statins are a class of drugs that lowers the level of cholesterol in the blood by reducing the production of cholesterol by the liver. Recent findings have shown statins to offer some relief to patients with scleroderma and other rheumatic diseases. ISN.
Vaccinations such as flu shots and pneumonia shots are recommended for patients with scleroderma and other autoimmune diseases. However, scleroderma patients should always consult their physician before being vaccinated. ISN.
|Overview of Vaccinations and Autoimmunity
Seasonal Flu Vaccination
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