Rheumatoid Arthritis - When Do I Call the Doctor? (cont.)

Eye redness: Redness of the eyes can represent an infection of the eyes, which is more common in people with rheumatoid arthritis because of dryness of the eyes (Sjögren's syndrome). Redness can also result from blood vessel inflammation (vasculitis), especially when pain is present.

Vision loss of red/green color distinction: A rare complication of the commonly used rheumatoid arthritis drug hydroxychloroquine (Plaquenil) is injury to the retina (the light-sensing portion of the back of the eye). The earliest sign of retinal changes from hydroxychloroquine is a decreased ability to distinguish between red and green colors. This occurs because the vision area of the retina that is first affected by the drug normally detects these colors. People who are taking hydroxychloroquine who lose red/green color distinction should stop the drug and contact their doctor.

Nausea: Nausea is a common problem in patients with rheumatoid arthritis, usually because of the medications that are required to keep the joint inflammation minimized. Medications frequently used to treat rheumatoid arthritis that can cause nausea include nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen [Advil], naproxen [Aleve], and many others), prednisone and prednisolone, azathioprine (Imuran), and methotrexate (Rheumatrex, Trexall). Nausea is usually not serious, but it is always annoying. Depending on the particular situation, the doctor may have the options of stopping the drug, lowering the dose, and/or adding a medication to treat the nausea.

Vomiting: Vomiting can be caused by the same drugs that cause nausea. Obviously, it is also possible to have a new underlying condition that could cause vomiting. It is most important to notify the doctor about this symptom, not only because of what it could represent, but also because it can lead to dehydration. Dehydration is never good for patients taking arthritis medications as it can increase the chances for side effects of the drugs, such as kidney injury.