All About NSAIDs and other Drug Pain Relief Options

The facts Put Simply





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Important Facts About the Most Common Medicinal Pain Relievers:
1) Traditional NSAIDs
2) COX-2 Inhibitors
3) Salicylates

DRUG BRAND(S) DOSAGE SPECIAL
INSTRUCTIONS
POSSIBLE
SIDE EFFECTS
BE AWARE
Traditional NSAIDs
Diclofenac potassium Cataflam 100 to 200 mg per day in 2 or 4 doses. For all traditional NSAIDs:
Do not take with other prescription or OTC NSAIDs. Take as directed at the same time every day. Take with food or an antacid.

For OTC NSAIDs:
Do not take for more than 10 days for pain or more than 3 days for fever unless directed by a doctor.

For all NSAIDs:
Abdominal or stomach cramps, pain or discomfort; diarrhea; dizziness; drowsiness; edema (swelling of the feet); gastrointestinal bleeding; headache; heartburn or indigestion; nausea or vomiting; peptic ulcer. All NSAIDs may cause an increased risk of serious blood clots, heart attacks and stroke, which can be fatal. This risk may increase with dose and duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk. These drugs should not be used for pain in people having coronary bypass surgery.

For diclofenac sodium with misoprostal only:
Same as other NSAIDs except risk of gastric ulcers is decreased; risk of abdominal pain and diarrhea is increased

For all traditonal NSAIDs:
Before taking these drugs, let your doctor know if you drink alcohol or use blood thinners or if you have or have had any of the following: sensitivity or allergy to aspirin or similar drugs, kidney or liver disease, heart disease, high blood pressure, asthma or stomach ulcers. Because stomach ulcers or internal bleeding can occur without warning, regular checkups are important. Patients on long-term NSAIDs should have blood counts and liver enzymes checked periodically. With diclofenac, liver enzymes should be checked within four to eight weeks of starting the drug.

For mefenamic acid only:
This medication is for short-term relief of pain and should not be used for more than 7 days.

For all traditonal NSAIDs:
Unlike low-dose aspirin, there is little evidence that NSAIDs will protect against heart attack or stroke. NSAIDs may be used with low-dose aspirin, but doing so may slightly increase risk of gastric bleeding. Before taking NSAIDs, tell your doctor if you take ACE inhibitors, lithium, warfarin or furosemide. Using ibuprofen along with low-dose aspirin may interfere with aspirin's effect in preventing heart attacks.

Diclofenac sodium Voltaren 100 to 200 mg per day in 2 or 4 doses
  Voltaren XR 100 mg per day in a single dose
Diclofenac sodium with misoprostol Arthrotec 150 to 200 mg per day in 2 to 4 doses.
Diflunisal Dolobid 500 to 1,500 mg per day in 2 doses
Etodolac Lodine 600 to 1,200 mg per day in 2 or 3 doses.
  Lodine XL 600 mg per day in a single dose
Fenoprofen calcium Nalfon 900 to 2,400 mg per day in 3 or 4 doses; never more than 3,200 mg per day
Flurbiprofen Ansaid 200 to 300 mg per day in 2 to 4 doses
Ibuprofen Prescription:
Motrin
1,200 to 3,200 mg per day in 3 or 4 doses
  Non-prescription:
Advil, Motrin IB, Nuprin
200 to 400 mg every 4 to 6 hours as needed, no more than 1,200 mg per day
Indomethacin Indocin 50 to 200 mg per day in 2 to 4 doses
  Indocin SR 75 mg per day in a single dose or 150 mg per day in 2 doses
Ketoprofen Presciption:
Orudis, Oruvail

200 to 225 mg per day in 3 or 4 doses
150 or 200 mg per day in a single dose
  Non-prescription:
Actron, Orudis KT

12.5 mg every 4 to 6 hours as needed
Meclofenamate sodium Meclomen 200 to 400 mg per day in 4 doses
Mefenamic acid Ponstel 500 mg initial dose, then 250 mg every 6 hours as needed, for up to 7 days
Meloxicam Mobic 7.5 mg to 15 mg per day in a single dose
Nabumetone Relafen 1,000 mg per day in 1 or 2 doses; 2,000 mg per day in 2 doses.
Naproxen Naprosyn 500 to 1,500 mg per day in 2 doses
  Naprelan 750 mg or 1,000 mg per day in a single dose
Naproxen sodium Prescription:
Anaprox
550 to 1,650 mg per day in 2 doses
  Non-prescription:
Aleve
220 mg every 8 to 12 hours as needed
Oxaprozin Daypro 1,200 mg or 1,800 mg per day in a single dose
Piroxicam Feldene 20 mg per day in 1 or 2 doses
Sulindac Clinoril 300 to 400 mg per day in 2 doses
Tolmetin sodium Tolectin 1,200 to 1,800 mg per day in 3 doses See Above See Above See Above
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COX-2 Inhibitors
DRUG BRAND(S) DOSAGE SPECIAL
INSTRUCTIONS
POSSIBLE
SIDE EFFECTS
BE AWARE
Celecoxib Celebrex For ankylosing spondylitis or OA:
200 mg per day in 1 or 2 doses

For RA:
100 to 200 mg twice per day

Do not take with other prescription or OTC NSAIDs. Do not take late in pregnancy. Same as traditional NSAIDs, except less likely to cause bleeding and ulcers. Serious skin reactions or stomach problems, such as bleeding, can occur without warning. The most common side effects are indigestion, diarrhea and stomach pain. Unlike low-dose aspirin, there is no evidence these drugs will protect against heart attack or stroke. Celecoxib may be used with low-dose aspirin, but may slightly increase ulcer risk. Before taking Celebrex, tell your doctor if you have had a heart attack, stroke, angina, blood clot, hypertension or sensitivity to aspirin or other NSAIDs. Tell your doctor if you have a sensitivity to sulfonamides, a type of sulfa drug, or to aspirin or other arthritis medications.
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Salicylates
DRUG BRAND(S) DOSAGE SPECIAL
INSTRUCTIONS
POSSIBLE
SIDE EFFECTS
BE AWARE
ACETYLATED SALICYLATES
Aspirin
(acetylsalicylic acid)
Non-prescription:
Anacin, Ascriptin, Bayer, Bufferin, Ecotrin, Excedrin tablets
2,400 to 5,400 mg per day in several doses For all salicylates:
Take with food. Do not chew tablets; do not crush enteric-coated or time-release pills or mix with water. Do not combine with other NSAIDs.
For all salicylates:
Abdominal or stomach cramps, pain or discomfort; diarrhea; dizziness; drowsiness or light-headedness; edema (swelling of the feet); headache; heartburn or indigestion; nausea or vomiting
For acetylated salicylates:
Ulcers and internal bleeding can occur without warning, so regular checkups are important. Confusion, deafness, dizziness, or ringing in the ears indicates you are taking too much. Before taking this drug, let your doctor know if you drink alcohol, use blood thinners or have any of the following: sensitivity or allergy to aspirin or similar drugs, kidney disease, liver disease, asthma or peptic ulcers.

For nonacetylated salicylates:
Dizziness, deafness or ringing in the ears indicates that you are taking too much. Before taking these medications, let your doctor know if you drink alcohol or use other NSAIDs.

For all salicylates:
If you are taking doses of more than 3,600 mg per day, your doctor should monitor salicylate levels in your blood.

NON-ACETYLATED SALICYLATES
Choline and magnesium salicylates
CMT, Tricosal, Trilisate 2,000 to 3,000 mg per day in 2 or 3 doses
Choline salicylate
(liquid only)
Arthropan 3,480 or 20 mL per day in several doses
Magnesium salicylate Prescription:
Magan, Mobidin, Mobogesic
2,600 to 4,800 mg per day in 3 to 6 doses
  Non-prescription:
Arthritab, Bayer Select, Doan's Pills
Salsalate Amigesic, Anaflex 750, Disalcid, Marthritic, Mono-Gesic, Salflex, Salsitab 1,000 to 3,000 mg per day in 2 or 3 doses
Sodium salicylate Available as generic only 3,600 to 5,400 mg per day in several doses
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