Medication, along with physical activity, is often the first line of treatment for ankylosing spondylitis (AS). Sometimes these drugs may cause side effects. Different people may respond differently, so it’s important to take the time to find medications that work best for you.
NSAIDS
These are often the first drugs doctors prescribe for AS. Nonsteroidal anti-inflammatory drugs (NSAIDs) include:
High doses may thin the protective mucus in your stomach. Over time, this can lead to side effects such as:
- Heartburn
- Inflammation of your stomach lining
- Ulcers
- Bleeding
- Higher risk of heart attack or stroke if you have a history of heart disease
IL-17 Inhibitors
These biologic drugs helps lower inflammation. Two IL-17 inhibitors are secukinumab (Cosentyx) and ixekizumab (Taltz).
Biologics may cause some side effects as well, including:
- Inflammatory bowel disease (IBD). These drugs could cause IBD or worsen symptoms in people who already have this condition.
- Infections. These biologics may raise your chance of infection and could make it harder to fight them off.
- Cancer. In lab tests, mice had a higher risk of cancer after IL-17 inhibitors. But this risk is still unclear in humans.
JAK inhibitors
JAK inhibitors also help lower inflammation in the intestine and other organs. Tofacitinib (Xeljanz, Xeljanz-XR) is taken in pill form.
Some side effects include:
- Headache
- Diarrhea
- Fatigue
- Rapid heartbeat
- Risk of liver disease
Corticosteroids
These aren’t commonly used to treat AS. An injection of these steroids sometimes may treat inflammation and pain from AS. These drugs can cause side effects that may include:
- A larger appetite
- Weight gain
- Mood changes
- Easy bruising
- Weakened muscles
- Blurry vision
- Growth of more body hair
- Lower ability to fight infection
- Swelling or acne in your face
- Osteoporosis
- Diabetes or worsened diabetes
- High blood pressure
- Stomach problems
- Difficulty sleeping
- Cataracts or glaucoma
- Inflammation
Side effects may differ for each person and some people may not have any at all.
Sulfasalazine
You might take this drug orally if NSAIDs haven’t helped your AS symptoms, especially if you have pain in joints in your shoulders, hands, or feet. Side effects from sulfasalazine (Azulfidine) are rare, but might include:
Methotrexate
You can take this drug as an injection or an oral tablet. It’s important to take folic acid vitamins to help offset the side effects of this medication. They include:
- Nausea and vomiting
- Ulcers or sores
- Headaches
- Fatigue
- An overall feeling of being unwell
How to Handle Side Effects
Tell your doctor if you notice changes in your body that you think may be caused by your AS treatment. They may be able to adjust your dosage or switch medications.
Sometimes, your doctor will suggest another treatment to go alongside your current one. This second medication may stop your uncomfortable symptoms. Your doctor will work with you until you find a therapy that works best for you with fewest side effects.
