What Not to Take When You Have Arthritis: Medications, Supplements, and Foods to Avoid

October 6, 2025 •

5 min read

According to the CDC, over 54 million US adults have arthritis, and managing the condition effectively goes beyond taking the right medication—it also means knowing what to avoid. Being mindful of what not to take when you have arthritis can prevent dangerous drug interactions, liver damage, and exacerbated inflammation, safeguarding your health.

Quick Summary

Overview of medications, supplements, and foods that pose risks for arthritis patients due to drug interactions, increased inflammation, or other adverse effects. Understanding these risks is crucial for patient safety and effective disease management.

Key Points

Consult a Doctor First: Never start, stop, or combine medications or supplements without consulting your healthcare provider, due to potential interactions and side effects.
Monitor NSAID Use: Be cautious with NSAIDs like ibuprofen, especially with long-term use, as they can cause heart problems, kidney damage, and GI bleeding, particularly when combined with alcohol or corticosteroids.
Avoid Alcohol and Methotrexate/Acetaminophen: Combining alcohol with methotrexate or high-dose acetaminophen significantly increases the risk of liver damage.
Be Wary of Unproven Supplements: Avoid supplements like Chaparral, oral Arnica, and Blue-Green Algae (Spirulina), as they carry significant health risks, liver toxicity, or may worsen autoimmune conditions.
Minimize Inflammatory Foods: Reduce intake of processed foods, refined sugars, unhealthy omega-6 oils, excessive salt, and red/fried meats, which can trigger or exacerbate systemic inflammation.
Check for Hidden Ingredients: Read labels carefully, especially for OTC products, to avoid accidental overdose of acetaminophen or interactions with NSAID-containing cold and flu remedies.
Consider Food and Medication Interactions: Be aware of specific food interactions, such as grapefruit juice with certain medications (colchicine, cyclosporine), and calcium-containing dairy with specific antibiotics.

For individuals managing arthritis, the path to pain relief and reduced inflammation is not just about which treatments to embrace, but also which to avoid. Improper use of common medications, seemingly harmless supplements, and certain dietary choices can worsen symptoms, cause organ damage, or trigger dangerous drug interactions. Prioritizing caution and informed decisions can significantly improve safety and treatment outcomes.

Medications and Pain Relievers to Approach with Caution

Many common over-the-counter (OTC) and prescription medications can be problematic for arthritis patients, especially with long-term use or when combined with other drugs.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs, such as ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve), are widely used for arthritis pain and inflammation. While effective, they are not without risk.

Cardiovascular Risks: Long-term use or high doses can increase the risk of heart attack and stroke, especially for those with pre-existing heart conditions.
Gastrointestinal Bleeding: NSAIDs can cause stomach irritation, ulcers, and bleeding. This risk is amplified when combined with corticosteroids or excessive alcohol.
Kidney Damage: They can impair kidney function, particularly in older adults or those with pre-existing kidney disease, diuretics, or heart failure.
Drug Interactions: NSAIDs can interact with blood thinners (like warfarin), blood pressure medication, and diuretics, potentially diminishing their effectiveness or increasing side effects.

Acetaminophen (Tylenol)

Often recommended for mild to moderate osteoarthritis pain, acetaminophen has a different risk profile than NSAIDs. The main concern is liver damage, which can occur with high doses, prolonged use, or when combined with heavy alcohol consumption. Because acetaminophen is included in many OTC and prescription combination products, it is crucial to read labels carefully to avoid an accidental overdose.

Methotrexate

A traditional disease-modifying antirheumatic drug (DMARD) used for rheumatoid arthritis (RA), methotrexate has important interactions to consider.

Alcohol: Combining methotrexate with alcohol significantly increases the risk of liver damage, as both substances are processed by the liver.
NSAIDs: Concurrent use of NSAIDs with methotrexate can slow the clearance of methotrexate from the body, potentially leading to toxic levels. Regular monitoring is essential.

Corticosteroids

Prescribed for their powerful anti-inflammatory effects, corticosteroids like prednisone are not suitable for long-term, high-dose use due to numerous severe side effects.

Increased Ulcer Risk: Combining corticosteroids with NSAIDs dramatically increases the risk of gastric ulcers.
Metabolism Issues: Steroids can affect the metabolism of other drugs. For instance, prednisone can inhibit caffeine metabolism, leading to jitters or insomnia.

Supplements to Avoid or Use with Caution

Many herbal and dietary supplements are marketed for arthritis relief, but their efficacy is often unproven and safety is not guaranteed.

Supplements with Safety Concerns

Chaparral: Contains antioxidants but is known to be highly toxic to the liver. Even small amounts can lead to severe liver problems.
Arnica (oral): While some topical forms may be used for pain, taking arnica orally can cause serious adverse effects and can even be fatal. It should only be used under strict medical supervision.
Blue-Green Algae (Spirulina): For inflammatory conditions like RA, supplements that boost immune activity can worsen symptoms. Blue-green algae can have an immunostimulatory effect, making it a risky choice for RA patients.

Supplements with Drug Interactions or Mixed Evidence

Red Yeast Rice: Often used for cholesterol, it contains compounds similar to statin drugs. It can cause muscle and joint pain, and interfere with prescribed medications.
Cat's Claw: While some older studies suggest anti-inflammatory effects, the evidence is limited and inconsistent. It can cause side effects and interact with blood pressure and cholesterol medications.
Glucosamine: Can interact with blood thinners like warfarin, increasing the risk of bleeding. Diabetics should also use with caution, as it can affect blood sugar levels.

Foods and Beverages to Limit or Avoid

Dietary choices play a significant role in managing inflammation, especially for those with inflammatory arthritis. A diet rich in processed foods, unhealthy fats, and sugars can contribute to systemic inflammation and exacerbate symptoms.

Inflammatory Foods and Beverages

Processed Foods: Packaged snacks, fast food, and ready-made meals are often high in trans fats, added sugars, and sodium, all known to fuel inflammation.
Sugary Foods and Drinks: Refined sugars, including those in soda, candy, and fruit juices, trigger the release of inflammatory cytokines, making joint pain worse.
Salty Foods: High sodium intake can lead to water retention and increased inflammation. Limiting canned soups, cured meats, and salty snacks is advised.
Red Meat and Fried Foods: These are high in saturated fats and advanced glycation end products (AGEs), which are known to increase inflammation.
Certain Omega-6 Rich Oils: Oils like corn, sunflower, and soy are high in omega-6 fatty acids. While some are necessary, a high ratio of omega-6 to anti-inflammatory omega-3 fatty acids can promote inflammation.

Alcohol and Arthritis

Alcohol consumption requires careful consideration for arthritis patients.

Inflammation: Excessive alcohol can increase systemic inflammation.
Drug Interactions: As mentioned, alcohol interacts dangerously with methotrexate and NSAIDs.
Gout: For those with gout, a form of arthritis, alcohol—especially beer—is high in purines, which increase uric acid and can trigger painful flares.

Comparison of Medication Risks for Arthritis Patients


Medication Class	Primary Risk for Arthritis Patients	Key Interactions to Note	Risk Profile Summary
NSAIDs	GI bleeding, kidney damage, cardiovascular events	Blood thinners (warfarin), blood pressure meds, corticosteroids	Moderate to High, depending on patient health and duration of use
Acetaminophen	Liver damage with high doses or alcohol	Alcohol, other acetaminophen-containing products	Low-to-Moderate, with primary risk related to liver health and dose
Methotrexate	Liver damage with alcohol, toxicity with NSAIDs	Alcohol, NSAIDs, PPIs	High, especially if not closely monitored by a doctor
Corticosteroids	Gastric ulcers, numerous long-term side effects	NSAIDs (increased ulcer risk), Caffeine	High, particularly with long-term use and interactions

Conclusion: The Importance of Informed Decisions

Managing arthritis involves careful consideration of all substances entering the body, from prescription drugs to casual dietary choices. Medications that offer relief can also carry significant risks, especially when taken incorrectly or combined with other drugs or alcohol. Many supplements are not regulated and can pose hidden dangers, while common foods can contribute to the very inflammation you are trying to combat. Always consult your doctor or pharmacist before starting or stopping any medication or supplement, even if it's available over-the-counter. They can help you navigate these complexities safely and create a comprehensive treatment plan that minimizes risk while maximizing symptom relief. For reliable information on managing arthritis, consult resources like the Arthritis Foundation.

Frequently Asked Questions

You should not take NSAIDs like ibuprofen with certain blood pressure medications without consulting your doctor. NSAIDs can interfere with the effects of blood pressure medicines, potentially reducing their effectiveness.

No, it is not safe. Combining alcohol with methotrexate significantly increases the risk of liver damage, as both can place a strain on the liver. Always discuss alcohol consumption with your doctor.

To help reduce inflammation, you should limit or avoid processed foods, sugary drinks and treats, red meat, fried foods, excessive salt, and unhealthy omega-6 oils.

Yes. Supplements like Chaparral, oral Arnica, and Blue-Green Algae (Spirulina) can be toxic or worsen autoimmune conditions. Always research and consult a healthcare provider before taking any supplement.

Yes, grapefruit juice can interact with several medications by increasing their blood levels. This is known to occur with drugs like colchicine (for gout) and cyclosporine (a DMARD), which can lead to dangerously high levels of the drug.

Yes. Taking high doses of acetaminophen, or even regular doses when you consume three or more alcoholic drinks daily, significantly increases the risk of liver damage and liver failure.

Long-term, high-dose use of corticosteroids is associated with serious side effects, including increased risk of infection, bone density loss, and cardiovascular problems. They are typically reserved for short-term control of severe flares.

Yes, for specific medications. The calcium in dairy products can interfere with the absorption of certain drugs, such as some antibiotics (e.g., tetracycline), making them less effective.