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Medications That May Trigger Psoriatic Arthritis: What to Know and How to Manage It

Psoriatic arthritis (PsA) is a chronic autoimmune condition that causes joint pain, swelling, and stiffness, often in people with psoriasis. While genetics and immune system dysfunction are the main causes, certain medications can trigger or exacerbate psoriatic arthritis symptoms, making it essential to know what to watch for and how to respond if flare-ups occur.

If you have a family history of autoimmune disease, psoriasis, or existing joint issues, knowing which drugs to avoid—or use with caution—could help prevent long-term damage.

Common Medications Linked to Psoriatic Arthritis Flare-Ups

While not everyone will react the same way, the following medications have been associated with the onset or worsening of psoriatic arthritis symptoms in some individuals:

  • Beta-Blockers (e.g., atenolol, metoprolol)

Often used for high blood pressure or heart conditions; linked to worsening psoriasis and PsA in some patients.

  • Lithium

Commonly used to treat bipolar disorder; known to trigger psoriasis and joint inflammation in sensitive individuals.

  • Antimalarials (e.g., hydroxychloroquine)

Sometimes used to treat lupus and rheumatoid arthritis but may cause psoriasis or PsA flares in predisposed people.

  • NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)

Ironically, while used to manage inflammation, long-term use may irritate gut and immune responses, triggering autoimmune reactions.

  • Tetracycline antibiotics

These can disrupt gut flora and may play a role in immune dysregulation in genetically predisposed individuals.

Always consult your healthcare provider before discontinuing any medications. In some cases, the benefits may outweigh the risks, and alternatives can be explored.

Treatment Options for Psoriatic Arthritis

Whether your PsA was triggered by medication or another cause, a range of treatment options can help manage symptoms and prevent joint damage:

1. Disease-Modifying Antirheumatic Drugs (DMARDs)

  • Methotrexate, leflunomide, sulfasalazine
  • These drugs slow the progression of joint damage and reduce systemic inflammation.

2. Biologic Therapies

  • TNF inhibitors: Enbrel, Humira, Remicade
  • IL-17 and IL-23 inhibitors: Cosentyx, Taltz, Skyrizi
  • Biologics target specific immune pathways and are highly effective in treating moderate to severe PsA.

3. Targeted Synthetic DMARDs

  • JAK inhibitors like Tofacitinib (Xeljanz)
  • PDE4 inhibitors like Apremilast (Otezla)
  • These oral medications provide another option for patients who prefer pills over injections.

4. Lifestyle and Complementary Therapies

  • Anti-inflammatory diet (omega-3s, leafy greens, avoiding sugar and gluten)
  • Physical therapy to maintain mobility and joint function
  • Stress management, which can reduce flare frequency

Conclusion

While psoriatic arthritis is primarily driven by autoimmune and genetic factors, certain prescription medications can act as unexpected triggers, especially in people already at risk. If you notice joint pain, stiffness, or swelling after starting a new drug, speak with your doctor right away. By identifying the cause and starting the right treatment early, you can protect your joints, minimize pain, and live well with PsA.

Sources

National Psoriasis Foundation – https://www.psoriasis.org

Mayo Clinic – https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis

Cleveland Clinic – https://my.clevelandclinic.org/health/diseases/10986-psoriatic-arthritis

NIH MedlinePlus – https://medlineplus.gov

Johns Hopkins Arthritis Center – https://www.hopkinsarthritis.org