Managing Sjogren's Syndrome often involves juggling multiple medications, each with its potential benefits and drawbacks. As a physician and a fellow Sjogren's patient, I understand this balancing act from experience. In this article, we'll explore common Sjogren's medications, their potential side effects, and – most importantly – strategies for minimizing risks and optimizing your long-term health.

Your Sjogren’s Toolkit: A Multifaceted Approach

Think of your Sjogren's treatment plan as your personalized toolkit. It’s about creating a collection of strategies that work best for you. Let's explore what’s often inside:

Over-the-Counter Essentials: Managing Dryness

Those hallmark Sjogren's symptoms –– dry eyes and dry mouth –– can be intensely uncomfortable! These OTC remedies offer front-line relief:

• Artificial Tears: These lubricating drops, gels, and ointments provide soothing moisture and protect delicate eye tissues. Experiment to find what works best! For frequent use (more than four times daily), preservative-free formulations in individual vials are gentler on your eyes. Tip: After using drops, close your eyes for 2–3 minutes to allow the medication to fully absorb.

• Oral Moisturizers: Gels, sprays, and lozenges offer relief from dry mouth discomfort. Many contain xylitol, which might trigger symptoms in people with irritable bowel syndrome (IBS) –– so pay attention to how your body responds.

• Sugar-Free Gum: Chewing sugar-free gum stimulates saliva production – a simple and sustainable strategy for managing dry mouth.

Prescription Medications: Targeting Inflammation & Immune Response

These medications target the underlying causes of Sjogren's, helping to regulate the immune system and reduce inflammation:

• Hydroxychloroquine (Plaquenil): This disease-modifying antirheumatic drug (DMARD) helps calm an overactive immune response. While generally safe, regular eye exams are crucial to monitor for potential vision changes. Tummy troubles or skin rashes can also occur.

• Methotrexate: This DMARD works differently than hydroxychloroquine, suppressing the immune system. Regular blood tests are necessary to monitor liver function. Fatigue and mouth sores are other potential side effects. Methotrexate is often given with folic acid to minimize these.

• Corticosteroids (e.g., prednisone): These powerful anti-inflammatories provide rapid relief from flares but are not for long-term use. They carry significant risks, including bone thinning (osteoporosis), weight gain, increased appetite, metabolic changes (blood sugar, blood pressure), and even mood changes. Your doctor will work with you to find the lowest effective dose for the shortest duration possible.

• Rituximab: Reserved for severe cases, this medication depletes B-cells (the immune cells that produce antibodies). It’s given intravenously and might cause infusion reactions. Rituximab can significantly lower your immune defenses, so infection prevention is paramount!

Sjogren's and Your Long-Term Health: A Holistic Approach

Managing Sjogren's is about more than just medications. Here are strategies for minimizing risks and staying healthy:

• Build a Strong Healthcare Team: Regular checkups with your primary care physician and specialists (ophthalmologist, rheumatologist, etc.) are essential for monitoring your overall health, including bone health (Sjogren's increases your risk of osteoporosis).

• Embrace a Healthy Lifestyle: Nutrition, exercise, and stress management play crucial roles in supporting your body and minimizing medication side effects.

My Perspective: A Doctor & Patient Navigating Sjogren’s Medications

As both a physician and a patient with Sjogren's, I’ve experienced medication side effects firsthand –– those corticosteroid mood swings can be real! It's why I prioritize:

• Staying informed about new treatments.

• Collaborating closely with my medical team.

• Regularly re-evaluating my treatment plan.

Let's Talk Sjogren's & Medications!

Remember, you're not alone. Building a strong partnership with your healthcare provider is crucial for managing Sjogren’s and its associated challenges.

Connect with other Sjogren's "superheroes" in my free Facebook group, "The Success with Sjogren’s Sisterhood," and download my free Sjogren’s Superhero Starter Kit for valuable resources! 

What questions or concerns do you have about Sjogren's medications?

What strategies have you found helpful for managing side effects?

Share your experiences and tips in the comments below!