Arthritis & the Flu

People with weakened immune systems are at high risk for serious flu complications if they get sick. Some types of arthritis and certain arthritis medications can weaken your immune system, putting you at greater risk of getting seriously sick if you get the flu.

• Certain arthritis medications such as steriods, disease-modifying antirheumatic drugs, and biological response modifiers may weaken your immune system. This puts you at risk for the flu.
• Get the flu vaccine. It is your best protection against the flu.
• If you have inflammatory arthritis you should get the flu shot, not the nasal spray.
• If you have flu-like symptoms, contact your health care provider immediately.

Why does having arthritis put me at higher risk for getting the flu?

Not all people with arthritis are at high risk for the flu. People with inflammatory arthritis have a higher risk of flu-related complications, such as pneumonia. 

Types of inflammatory arthritis that may weaken the immune system include:

• Rheumatoid arthritis (RA)
• Systemic lupus erythematosus (SLE)
• Psoriatic arthritis
• Anti-phospholipid syndrome
• Polymyalgia rheumatic
• Systemic sclerosis/scleroderma
• Spondyloarthropathies
• Sjögren’s syndrome
• Polymyositis/dermatomyositis
• Vasculitis (for example, giant cell arteritis)
• Necrotising arteritis
• Sarcoidosis
• Polyarteritis nodosa

Arthritis medications that may weaken your immune system include:

• Steriods (corticosteroids) taken by mouth or intravenously—not those applied to the skin or injected into a joint.
  • prednisone (Deltasone, Orasone, Prednicin-M, Sterapred)
  • prednisolone (Prelone)
  • methlyprednisone (Medrol)
  • hydrocortisone (Cortef, Hydrocortone)
  • dexamethasone (Decadron, Hexadrol)
  • cortisone acetate (Cortone)
  • betamethasone (Celestone)
• DMARDs (disease-modifying antirheumatic drugs)
  • methotrexate (Rheumatrex, Trexall)
  • azathioprine (Imuran, Azasan)
  • hydroxychloroquine (Plaquenil)
  • leflunomide (Arava)
  • sulfasalazine (Azulfidine)
• Biological response modifiers (Biologics)
  • etanercept (Enbrel)
  • infliximab (Remicade)
  • adalimumab (Humira)
  • anakinra (Kineret)
  • abatacept (Orencia)
  • rituximab (Rituxan)
  • tacrolimus (Prograf, FK-506, fujimycin)

This list applies to medications that are ingested or injected and does not include medications that are applied to the skin such as creams and ointments. Your health care provider can tell you if the medications you take weaken your immune system.

How can I protect myself from getting the flu?

Getting the flu vaccine is the most effective way to prevent the flu. Get it as soon as it is available in your area. People with inflammatory arthritis should get a flu shot, not the nasal spray vaccine.

In addition to getting vaccinated, follow our everyday steps to keep yourself healthy this flu season.

I think I have the flu. What should I do?

If you have any flu-like symptoms, contact your health care provider. Do not stop taking any medicine you take for your arthritis unless told to do so by your physician. If you have the flu your health care provider can prescribe antiviral medications to treat the flu.

In addition, follow our treatment recommendations.

Related Links

Arthritis and Influenza