Safe use of non-steroidal anti-inflammatory drugs (NSAIDs)

Extract

• Consider the different pain management options.
  • Non-pharmacological methods
  • Oral non-steroidal anti-inflammatory drugs (NSAIDs)
  • Topical NSAIDs
  • Paracetamol
  • Codeine, tramadol
  • Drugs for neuropathic pain, see Polyneuropathies1 Chronic pain2.
• An NSAID is usually justified in the treatment of inflammatory rheumatic disease and acute pain (such as injury, back pain, migraine, menstrual pain).
• Check the need for long-term medication and the dose regularly.
  • Use the lowest effective dose.
• Consider the possibility of drug interactions and contraindications (use electronic tools if available).
• Assess the benefits and risks involving the gastrointestinal tract, cardiovascular system and kidneys, particularly in patients aged 65 or more.
  • Short-acting preparations may be safer.
  • Topical products are absorbed through the skin and have very few systemic effects.
  • For patients with heart disease or its risk factors (hypertension, diabetes, high cholesterol level or smoking) or renal failure, choose primarily a topical NSAID or paracetamol.
    • If, however, an oral NSAID is needed, use the lowest effective dose for the shortest possible time.
  • If gastrointestinal risks are significant, use prophylactic antiulcer medication or choose a COX-2-selective NSAID.

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