Caffeine is not contraindicated for the common medications taken for RA, but it’s worth noting that it may either mitigate or worsen certain side effects of RA meds such as prednisone, methotrexate, and nonsteroidal anti-inflammatory drugs (NSAIDs).
Prednisone Because one side effect of prednisone is insomnia, you might want to ditch the java and other highly caffeinated drinks if you are on the steroid and are having sleep issues.
Methotrexate If you’re taking methotrexate (Rheumatrex, Trexall), however, you may actually want to consider adding a little caffeine to your routine. When researchers followed people with RA on this disease-modifying antirheumatic drug for nearly a year, they found that of the people who had trouble tolerating the drug because of its unpleasant symptoms, more than half were fine when they took some caffeine, in the form of coffee or dark chocolate, along with their medicine. Another 13 percent experienced partial relief by adding caffeine.
NSAIDs Caffeine has been found to enhance the analgesic (pain-relieving) response to NSAIDs, leading to combination formulations, often aimed at headaches. But NSAIDs, which are commonly used for RA pain relief, as well as caffeine, can cause stomach upset in some people. Consuming both together could compound the irritation, which is something to be aware of, if you’re sensitive to GI side effects.
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