Arthritis Treatments: NSAIDS
| ARTHRITIS TREATMENTS: NSAIDS | ||||
|---|---|---|---|---|
| Generic & Class | Brand & Company | Strength(s) | Formulationsa | Usual Doseb |
| ACETIC ACIDS DERIVATIVES | ||||
| diclofenac | Cataflam
Novartis |
50mg | tabs | Adults: OA: 50mg 2–3 times daily. RA: 50mg
3–4 times daily. AS: 25mg 4 times daily, may add 25mg at bedtime.
Children: Not recommended. |
| (various) | 25mg, 50mg, 75mg | tabs (e-c) | Adults: OA: 50mg 2–3 times daily or 75mg twice daily.
RA: 50mg 3–4 times daily or 75mg twice daily. AS: 25mg 4 times daily, with an
additional 25mg at bedtime if necessary.
Children: Not recommended. |
|
| Voltaren XR
Novartis |
100mg | ext-rel tabs | Adults: OA: 100mg once daily. RA: 100mg once daily;
rarely 100mg twice daily may be used.
Children: Not recommended. |
|
| etodolac | (various) | 200mg, 300mg | caps | Adults: Initially 600mg–1g/day in 2–3 divided doses; usual max
1g/day in divided doses; may increase to 1.2g/day when needed.
Children: Not recommended. |
| 400mg, 500mg | tabs | |||
| 400mg, 500mg, 600mg | ext-rel tabs | Adults: 400mg–1g once daily; max 1.2g/day.
Children: Not recommended. |
||
| indomethacin | Indocin
Merck |
25mg, 50mg | caps | Adults: Acute gouty arthritis: 50mg 3 times daily until pain
tolerable; then rapidly reduce dose to discontinue. Other conditions: initially 25mg 2–3 times
daily. Increase if needed at weekly intervals by 25–50mg daily; max 200mg daily.
Children: <14 yrs: usually not recommended. ≥2 yrs: 1–2mg/kg/day in divided doses; max 3–4mg/kg/day (or 150–200mg/day whichever less). |
| 50mg | supp | |||
| Indocin Susp
Iroko |
25mg/5mL | susp | ||
| nabumetone | (various) | 500mg, 750mg | tabs | Adults: Initially 1g once daily; max 2g/day in 1 or 2 divided doses. Renal
insufficiency (CrCl 30–49mL/min): initial max 750mg once daily, may increase to 1.5g/day; (CrCl <30mL/min):
initial max 500mg once daily, may increase to 1g/day.
Children: Not recommended. |
| sulindac | Clinoril
Merck |
200mg+ | tabs | Adults: 150mg twice daily; max 400mg/day. Acute painful shoulder or gouty
arthritis: 200mg twice daily, usually for 7–14 days.
Children: Not recommended. |
| COX-2 INHIBITORS | ||||
| celecoxib | Celebrex
Pfizer |
50mg, 100mg, 200mg, 400mg | caps | Adults: ≥18yrs: OA: 200mg once daily or 100mg twice daily.
RA: 100–200mg twice daily. AS: 200mg in 1–2 divided doses; if no response after
6 weeks, 400mg once daily may be tried. <50kg: start at lowest recommended dose.
Children: <2yrs: not recommended. JRA: ≥2yrs (≥10kg to ≤25kg): 50mg twice daily; (>25kg): 100mg twice daily. |
| PROPIONIC ACIDS DERIVATIVES | ||||
| fenoprofen | Nalfon
Pedinol |
200mg, 400mg | caps | Adults: 300mg–600mg 3 or 4 times daily. Max: 3.2g/day.
Children: <18yrs: not recommended. |
| flurbiprofen | Ansaid
Pfizer |
50mg, 100mg | tabs | Adults: 200–300mg/day in 2–4 divided doses; max single dose 100mg.
Reduce dosage for renal impairment.
Children: Not recommended. |
| ibuprofen | (various) | 400mg, 600mg, 800mg | tabs | Adults: RA, OA: 400–800mg 3–4 times daily; max 3.2g/day.
Children: JRA: 30–40mg/kg per day in 3–4 doses. May use 20mg/kg per day in 3–4 doses for milder disease. |
| ketoprofen ext-rel | (various) | 200mg | ext-rel caps* | Adults: 200mg daily.
Children: Not recommended. |
| naproxen | Anaprox
Roche |
275mg | tabs | Adults: Arthritis,spondylitis: 275mg or 550mg twice daily. Tendinitis,
bursitis: Initially 550mg, then 550mg every 12 hrs or 275mg every 6–8 hrs; max 1.375g (first day),
then max 1.1g/day. Acute gout: 825mg once then 275mg every 8 hrs.
Children: <2yrs: not recommended. ≥2yrs: use susp form of naproxen. |
| Anaprox DS
Roche |
550mg | tabs | Adults: Arthritis,spondylitis: 275mg or 550mg twice daily. Tendinitis,
bursitis: Initially 550mg, then 550mg every 12 hrs or 275mg every 6–8 hrs; max 1.375g (first
day), then max 1.1g/day. Acute gout: 825mg once then 275mg every 8 hrs.
Children: <2yrs: not recommended. ≥2yrs: use susp form of naproxen. |
|
| Naprelan
Victory |
375mg, 500mg, 750mg | controlled-rel tabs | Adults: RA, OA, or AS: 750mg–1g once daily; max 1.5g once daily.
Acute tendonitis or bursitis: 1g once daily, or 1.5g once daily for a limited period; max 1g/day
thereafter. Gout: 1–1.5g once daily for 1 day then 1g once daily until attack subsides.
Children: Not recommended. |
|
| Naprosyn
Roche |
250mg, 375mg, 500mg | tabs | Adults: Arthritis, spondylitis: 250–500mg twice daily; max
1.5g/day (up to 6 months). Tendinitis, bursitis: 500mg once, then 500mg twice daily or 250mg every
6–8 hrs; max (first day) 1.25g, then max 1g/day. Acute gout: 750mg once, then 250mg
every 8 hrs.
Children: <2yrs: not recommended. ≥2yrs: JRA: 5mg/kg twice daily. Other uses: Doses of 2.5–5mg/kg/dose, max 15mg/kg/day have been used. |
|
| 125mg/5mL | susp | |||
| EC-Naprosyn
Roche |
375mg, 500mg | tabs (e-c) | Adults: 375–500mg twice daily.
Children: <2yrs: not recommended. ≥2yrs: use susp form. |
|
| oxaprozin | Daypro
Pfizer |
600mg | scored caplets | Adults: RA (≥16 years) or OA: 1.2 g once daily;
max 1.8 g or 26 mg/kg daily, whichever is less, in divided doses. Low body weight, milder disease, or on
dialysis: initially 600 mg once daily; max 1.2g daily.
Children: <6 years: not recommended. JRA: 6–16 years (22–31 kg): 600 mg once daily; (32–54 kg): 900 mg once daily; (≥55 kg): 1.2 g once daily. |
| Combination Therapy | ||||
| ibuprofen + famotidine | Duexisc
Horizon |
800mg/26.6mg | tabs | Adults: RA, OA: 800mg/26.6mg three times daily. Use lowest effective dose for
the shortest duration.
Children: Not recommended. |
| OXICAMS DERIVATIVES | ||||
| meloxicam | Mobic
Boehringer Ingelheim |
7.5mg, 15mg | tabs | Adults: ≥18yrs: 7.5mg once daily; max 15mg once daily. Hemodialysis: max 7.5mg/day.
Children: <2yrs: not recommended. JRA: ≥2yrs: 0.125mg/kg (max 7.5mg) once daily. |
| 7.5mg/5mL | susp | |||
| piroxicam | Feldene
Pfizer |
10mg, 20mg | caps | Adults: 20mg daily; may give in 2 divided doses.
Children: Not recommended. |
| SALICYLATES | ||||
| aspirin | Bayer
Bayer |
325mg | tabs, caplets, gelcaps | Adults: RA, arthritis and pleurisy of SLE: initially 3g daily in
divided doses; target plasma salicylate level 150–300micrograms/mL. OA: up to 3g/day in
divided doses.
Spondyloarthropathies: up to 4g/day in divided doses.
Children: JRA: initially 90–130mg/kg per day in divided doses; target plasma salicylate level 150–300micrograms/mL. |
| Ecotrin
GlaxoSmithKline |
81mg, 325mg, 500mg | tabs (e-c) | ||
| Extra Strength Bayer
Bayer |
500mg | caplets, gelcaps | ||
| Zorprin
Par |
800mg | tabsd | ||
| choline magnesium trisalicylate | (various) | 500mg, 750mg, 1g | scored tabs | Adults: 3g daily at bedtime or in 2 divided doses. Elderly: 750mg three
times daily.
Children: <12kg: not recommended. 12–37kg: 50mg/kg/day. >37kg: 2.25g/day. Both in 2 divided doses. |
| 500mg/5mL | soln | |||
| diflunisal | (various) | 250mg, 500mg | tabs | Adults: 250–500mg twice daily; max 1.5g/day.
Children: Not recommended. |
| salsalate | (various) | 500mg, 750mg | scored tabs | Adults: 3g daily in divided doses.
Children: Not recommended. |
| 500mg | caps | |||
| NOTES | ||||
|
a cap = capsules; tabs = tablets; e-c = enteric coated; ext-rel = extended-release; supp = suppositories; susp = suspension; + = scored b OA: OA = Osteoarthritis; RA = Rheumatoid arthritis; AS = Ankylosing spondylitis; JRA = Juvenile rheumatoid arthritis c Duexis is a fixed-combination tablet of ibuprofen and famotidine indicated for the relief of signs/symptoms of RA and OA and to decrease the risk of developing upper gastrointestinal ulcers (eg, gastric and/or duodenal ulcer), in patients who are taking ibuprofen for those indications. d pH dependent release Not an inclusive list. Some of the products listed above have additional indications. See Alphabetical and Section indexes. (Rev. 1/2013) |
||||
