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BROWSE topics
NSAID's
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Acetic acid derivatives |
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Arthrotec (diclofenac/ misoprostol):
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ARTHROTEC is indicated for treatment of the signs and symptoms of
osteoarthritis or rheumatoid arthritis in patients at high risk of
developing NSAID-induced gastric and duodenal ulcers and their
complications. See WARNINGS, Gastrointestinal Effects - Risk of
Ulceration, Bleeding and Perforation for a list of factors that may
increase the risk of NSAID-induced gastric and duodenal ulcers and their
complications. ---------- Dosage: Adults: Arthrotec® 50: Osteoarthritis: 1 tablet 2-3 times/day Rheumatoid arthritis: 1 tablet 3-4 times/day For both regimens, if not tolerated by patient, the dose may be reduced to 1 tablet twice daily Arthrotec® 75: Patients who cannot tolerate full daily Arthrotec® 50 regimens: 1 tablet twice daily Note: The use of these tablets may not be as effective at preventing GI ulceration Supplied: Tablet: Diclofenac sodium 50 mg and misoprostol 200 mcg; diclofenac sodium 75 mg and misoprostol 200 mcg |
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diclofenac (Voltaren ® Cataflam ®)
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Dosing (Adults): Analgesia/primary dysmenorrhea: Starting dose: 50 mg orally 3 times daily. Maximum dose: 150 mg/day. Rheumatoid arthritis: 150-200 mg/day orally in 2-4 divided doses (100 mg/day of sustained release product). Osteoarthritis: 100-150 mg/day orally in 2-3 divided doses (100-200 mg/day of sustained release product). Supplied: (Cataflam® - fastest onset of action) 50 mg tablet (K+ salt). (Voltaren®) Delayed release (enteric coated tab - Na+ salt): 25 mg, 50 mg, 75 mg. (Voltaren®-XR) Extended release tab: 100 mg Maximum Daily Dose: 225 mg; XR: 200 mg |
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Etodolac (Lodine ® )
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Dosing (Adults): Oral:
(May be taken with food to decrease GI distress.) Acute pain: 200-400 mg every 6-8 hours, as needed, not to exceed total daily doses of 1200 mg; for patients weighing <60 kg, total daily dose should not exceed 20 mg/kg/day Rheumatoid arthritis, osteoarthritis: Initial: 600-1200 mg/day given in divided doses: 400 mg 2 times/day; 300 mg 2 or 3 times/day; 500 mg 2 times/day; total daily dose should not exceed 1200 mg; for patients weighing <60 kg, total daily dose should not exceed 20 mg/kg/day Lodine® XL: 400-1000 mg once daily Supplied: Capsule (Lodine®): 200 mg, 300 mg Tablet: 400 mg, 500 mg Tablet, extended release (Lodine® XL): 400 mg, 500 mg, 600 mg Maximum Daily Dose:: 1200 mg |
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Indomethacin (Indocin® ) :
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Indications Indomethacin has been found effective in active stages of the following: Moderate to severe rheumatoid arthritis including acute flares of chronic disease. Moderate to severe ankylosing spondylitis. Moderate to severe osteoarthritis. Acute painful shoulder (bursitis and/or tendinitis). Acute gouty arthritis. [May cause GI upset, bleeding, ulceration, perforation; take with food or milk to minimize GI upset.] Dosing (Adults): 25-50 mg/dose 2-3 times/day; maximum dose: 200 mg/day; extended release capsule should be given on a 1-2 times/day schedule; maximum dose for sustained release is 150 mg/day. Elderly: Refer to Adults dosing; best to start older adults on 25 mg dose given 2-3 times/day Supplied: Capsule (Indocin®): 25 mg, 50 mg. Capsule, sustained release (Indocin® SR): 75 mg. Injection, powder for reconstitution, as sodium trihydrate (Indocin® I.V.): 1 mg Suspension, oral (Indocin®): 25 mg/5 mL (237 mL). Maximum Daily Dose: 200 mg; SR: 150mg |
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Ketorolac (Toradol ® )
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Dosing (Adults):
Pain (acute; moderately-severe):
IM: 60 mg x 1 or 30 mg q6h (maximum daily dose: 120 mg). IV: 30 mg x 1 or 30 mg q6h (maximum daily dose: 120 mg). Oral: 20 mg, followed by 10 mg every 4 to 6 hours (Max 40 mg/day). Oral dosing is intended to be a continuation of IM/IV therapy only. Dosing (EXCEPTIONS): Elderly (>65 yo - elderly pts have increased incidence of GI bleeding, ulceration, and perforation. Also decreased clearance), Renal insufficiency or weight <50 kg: IM: 30 mg x1 or 15 mg q6h (maximum daily dose: 60 mg) IV: 15 mg x 1 or 15mg q6h (maximum daily dose: 60 mg) Oral: 10 mg every 4-6 hours (max 40 mg/day). Renal dosing: Do not use in patients with advanced renal impairment. Patients with moderately-elevated serum creatinine should use half the recommended dose, not to exceed 60 mg/day IM/IV. Maximum Daily Dose: IV/ IM:120 mg; oral: 40mg |
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Sulindac (Clinoril ®)
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Indications Carefully consider the potential benefits and risks of CLINORIL and other treatment options before deciding to use CLINORIL. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals. CLINORIL is indicated for acute or long-term use in the relief of signs and symptoms of the following: Osteoarthritis Rheumatoid arthritis** Ankylosing spondylitis Acute painful shoulder (Acute subacromial bursitis/supraspinatus tendinitis) Acute gouty arthritis ** The safety and effectiveness of CLINORIL have not been established in rheumatoid arthritis patients who are designated in the American Rheumatism Association classification as Functional Class IV (incapacitated, largely or wholly bedridden, or confined to wheelchair; little or no self-care). Dosage: Adults: 150-200 mg twice daily or 300-400 mg once daily; not to exceed 400 mg/day. [Should be administered with food or milk.] Supplied: Tablet: 150 mg, 200 mg Maximum Daily Dose : 400 mg |
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Tolmetin (Tolectin ®)
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Use Treatment of rheumatoid arthritis and osteoarthritis, juvenile rheumatoid arthritis Dosage: Osteoarthritis and Rheumatoid Arthriti (Adult ): initial, 400 mg orally three times a day for 1-2 weeks. Maintenance: 200 to 600 mg orally three times a day. Maximum: 1800 mg/day. Supplied: 400 mg capsule. 200, 600 mg tab] Maximum Daily Dose : 1800 mg |
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Carboxylic acid derivatives |
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Diflunisal (Dolobid ®)
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Use Management of inflammatory disorders usually including rheumatoid arthritis and osteoarthritis; can be used as an analgesic for treatment of mild to moderate pain. Administration Tablet should be swallowed whole; do not crush or chew. Should be taken with food to decrease GI distress. Dosage: Adults: Oral: Osteoarthritis: 500-750 mg/day in divided doses. Pain: Initial: 500-1000 mg followed by 250-500 mg every 8-12 hours; maximum daily dose: 1.5 g Inflammatory condition: 500-1000 mg/day in 2 divided doses; maximum daily dose: 1.5 g Dosing adjustment in renal impairment: Clcr<50 mL/minute: Administer 50% of normal dose. Supplied: Tablet: 250 mg, 500 mg |
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Salsalate (Disalcid ®)
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Dosing (Adults):
3000 mg/day divided every 8 to 12 hours. Dosing comments in renal impairment: In patients with end-stage renal disease undergoing hemodialysis: 750 mg twice daily with an additional 500 mg after dialysis Supplied: Tablet: 500 mg, 750 mg |
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Enolic acid (oxicam) derivatives |
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Meloxicam (Mobic ®
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Use Relief of signs and symptoms of osteoarthritis and rheumatoid arthritis ---------- Dosage: Adults: Oral: Initial: 7.5 mg once daily; some patients may receive additional benefit from an increased dose of 15 mg once daily; maximum dose: 15 mg/day Elderly: Increased concentrations may occur in elderly patients (particularly in females); however, no specific dosage adjustment is recommended ---------- Dosage adjustment in renal impairment: Mild to moderate impairment: No specific dosage recommendations. Significant impairment (Clcr </= 15 mL/minute): Avoid use. Supplied: Suspension: 7.5 mg/5 mL (100 mL) Tablet: 7.5 mg, 15 mg Maximum Daily Dose : 15 mg |
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piroxicam (Feldene ®)
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Use Symptomatic treatment of acute and chronic rheumatoid arthritis and osteoarthritis. Dosage: Adults: 10-20 mg/day once daily; although associated with increase in GI adverse effects, doses >20 mg/day have been used (ie, 30-40 mg/day). May be taken with food to decrease GI adverse effect. ---------- Dosing adjustment in hepatic impairment: Reduction of dosage is necessary ---------- Monitoring Parameters Occult blood loss, hemoglobin, hematocrit, and periodic renal and hepatic function tests; periodic ophthalmologic exams with chronic use ---------- Supplied: Capsule: 10 mg, 20 mg Maximum Daily Dose : 20 mg |
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Napthylkanone derivatives |
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Nabumetone (Relafen ® )
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Dosing (Adults): Initial: 1000 mg orally with or without food. Some patients may obtain more symptomatic relief from 1500 mg to 2000 mg per day (in two divided doses). Dosages over 2000 mg per day have not been studied. ---------- Use Management of osteoarthritis and rheumatoid arthritis ---------- Supplied: Tablet: 500 mg, 750 mg Maximum Daily Dose: 2000 mg |
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Proprionic acid derivatives |
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Flurbiprofen (Ansaid ® )
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Dosing (Adults): 200-300 mg/day in 2 to 4 divided doses.
Do not administer more than 100 mg for any single dose; maximum: 300
mg/day. ---------- Use Oral: Treatment of rheumatoid arthritis and osteoarthritis ---------- Supplied: Tablet (Ansaid®): 50 mg, 100 mg Maximum Daily Dose: 300 mg |
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Ibuprofen (Motrin ® )
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Carefully consider the potential benefits and risks of MOTRIN tablets
and other treatment options before deciding to use MOTRIN. Use the
lowest effective dose for the shortest duration consistent with
individual patient treatment goals. MOTRIN tablets are indicated for relief of the signs and symptoms of rheumatoid arthritis and osteoarthritis. MOTRIN tablets are indicated for relief of mild to moderate pain. MOTRIN tablets are also indicated for the treatment of primary dysmenorrhea. Controlled clinical trials to establish the safety and effectiveness of MOTRIN tablets in children have not been conducted. ---------- Dosage: [Administer with food ] Oral: Children: Antipyretic: 6 months to 12 years: Temperature <102.5°F (39°C): 5 mg/kg/dose; temperature >102.5°F: 10 mg/kg/dose given every 6-8 hours (maximum daily dose: 40 mg/kg/day) Juvenile rheumatoid arthritis: 30-50 mg/kg/24 hours divided every 8 hours; start at lower end of dosing range and titrate upward (maximum: 2.4 g/day) Analgesic: 4-10 mg/kg/dose every 6-8 hours OTC labeling (analgesic, antipyretic): Children 6 months to 11 years: See table; use of weight to select dose is preferred; doses may be repeated every 6-8 hours (maximum: 4 doses/day)
---------------------------- Children >/= 12 years: 200 mg every 4-6 hours as needed (maximum: 1200 mg/24 hours) ---------------------------- Adults: Inflammatory disease: 400-800 mg/dose 3-4 times/day (maximum dose: 3200 mg/day) Analgesia/pain/fever/dysmenorrhea: 200-400 mg/dose every 4-6 hours (maximum daily dose: 1.2 g, unless directed by physician) OTC labeling (analgesic, antipyretic): 200 mg every 4-6 hours as needed (maximum: 1200 mg/24 hours) Dosing adjustment/comments in severe hepatic impairment: Avoid use Supplied: Caplet: 200 mg Capsule, liqui-gel: 200 mg Gelcap: Advil®: 200 mg Suspension, oral: 100 mg/5 mL (5 mL, 120 mL, 480 mL) Suspension, oral drops: 40 mg/mL (15 mL) Tablet: 200 mg, 400 mg, 600 mg, 800 mg Advil® Junior: 100 mg Tablet, chewable: 50 mg, 100 mg |
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Ketoprofen (Orudis ®)
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Use Acute and long-term treatment of rheumatoid arthritis and osteoarthritis; primary dysmenorrhea; mild to moderate pain ---------- Dosage: In order to minimize gastrointestinal effects, ketoprofen can be prescribed to be taken with food or milk. Oral: Children >/= 16 years and Adults: Rheumatoid arthritis or osteoarthritis: Capsule: 50-75 mg 3-4 times/day up to a maximum of 300 mg/day. Capsule, extended release: 200 mg once daily. Mild to moderate pain: Capsule: 25-50 mg every 6-8 hours up to a maximum of 300 mg/day OTC labeling: 12.5 mg every 4-6 hours, up to a maximum of 6 tablets/24 hours -------------- Elderly: Initial dose should be decreased in patients >75 years; use caution when dosage changes are made -------------- Dosage adjustment in renal impairment: Mild impairment: Maximum dose: 150 mg/day Severe impairment: Maximum dose: 100 mg/day Dosage adjustment in hepatic impairment and serum albumin <3.5 g/dL: Maximum dose: 100 mg/day. Supplied: Capsule: 50 mg, 75 mg Capsule, extended release (Oruvail®): 100 mg, 150 mg, 200 mg Tablet (Orudis® KT): 12.5 mg |
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Naproxen (Naprosyn ®)
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Dosing (Adults): Rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis: 250-500 mg orally twice daily. May increase to 1.5 g/day of naproxen base for limited time period. Acute gout: Initial: 750 mg x 1, followed by 250 mg every 8 hours until attack subsides. Mild-to-moderate pain, dysmenorrhea, acute tendonitis, bursitis: Initial: 500 mg x 1, then 250 mg every 6 to 8 hours. (Controlled release tablet): 375 to 1000 mg orally once daily.
Supplied: Tablet: 250 mg, 375 mg, 500 mg. Caplet/Gelcap: 220 mg (Na+ salt - equivalent to 200mg tablet - OTC). Suspension: 125 mg/5 ml. Tablet (sodium salt) Anaprox ®: 220mg, 275 mg, 550mg. Tablet (controlled release - Na+ salt): 421.5 mg, 550 mg. Tablet (delayed release) - EC-Naprosyn®: 375 mg, 500 mg.
Maximum Daily Dose: 1375 mg max |
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Oxaprozin (Daypro ® )
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Carefully consider the potential benefits and risks of DAYPRO and other
treatment options before deciding to use DAYPRO. Use the lowest effec-
tive dose for the shortest duration consistent with individual patient
treatment goals. DAYPRO is indicated: For relief of the signs and symptoms of osteoarthritis For relief of the signs and symptoms of rheumatoid arthritis For relief of the signs and symptoms of juvenile rheumatoid arthritis ------------------ Dosage: Adults: Osteoarthritis: 600-1200 mg once daily; patients should be titrated to lowest dose possible; patients with low body weight should start with 600 mg daily Rheumatoid arthritis: 1200 mg once daily; a one-time loading dose of up to 1800 mg/day or 26 mg/kg (whichever is lower) may be given Maximum daily dose: 1800 mg or 26 mg/kg (whichever is lower) in divided doses ------------------ Dosing adjustment in renal impairment: 600 mg once daily; dose may be increased to 1200 mg with close monitoring Dosing adjustment in hepatic impairment: Use caution in patients with severe dysfunction ------------------ Supplied: Tablet: 600 mg |
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COX-2 inhibitors |
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celecoxib (Celebrex ® )
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Carefully consider the potential benefits and risks of Celebrex
and other treatment options before deciding to use Celebrex. Use
the lowest effective dose for the shortest duration consistent
with individual patient treatment goals. Osteoarthritis (OA) Celebrex is indicated for relief of the signs and symptoms of OA Rheumatoid Arthritis (RA) Celebrex is indicated for relief of the signs and symptoms of RA Juvenile Rheumatoid Arthritis (JRA) Celebrex is indicated for relief of the signs and symptoms of JRA in patients 2 years and older Ankylosing Spondylitis (AS) Celebrex is indicated for the relief of signs and symptoms of AS Acute Pain (AP) Celebrex is indicated for the management of AP in adults Primary Dysmenorrhea (PD) Celebrex is indicated for the treatment of PD Familial Adenomatous Polyposis (FAP) Celebrex is indicated to reduce the number of adenomatous colorectal polyps in FAP, as an adjunct to usual care (e.g., endoscopic surveillance, surgery). It is not known whether there is a clinical benefit from a reduction in the number of colorectal polyps in FAP patients. It is also not known whether the effects of Celebrex treatment will persist after Celebrex is discontinued. The efficacy and safety of Celebrex treatment in patients with FAP beyond six months have not been studied. ---------- Dosage: Adults: Oral: Acute pain or primary dysmenorrhea: Initial dose: 400 mg, followed by an additional 200 mg if needed on day 1; maintenance dose: 200 mg twice daily as needed Osteoarthritis: 200 mg/day as a single dose or in divided dose twice daily Rheumatoid arthritis: 100-200 mg twice daily ---------- Elderly: No specific adjustment is recommended. However, the AUC in elderly patients may be increased by 50% as compared to younger subjects. Use the lowest recommended dose in patients weighing <50 kg. --------- Dosing adjustment in renal impairment: No specific dosage adjustment is recommended; not recommended in patients with advanced renal disease Dosing adjustment in hepatic impairment: Reduced dosage is recommended (AUC may be increased by 40% to 180%); decrease dose by 50% in patients with moderate hepatic impairment (Child-Pugh Class II) ------------------ Supplied: Capsule: 100 mg, 200 mg, 400 mg |
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Rofecoxib (Vioxx ® )
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No longer manufactured -
DISCONTINUED.: Osteoarthritis: 12.5 mg once daily; may be increased to a maximum of 25 mg once daily Acute pain: 50 mg orally once daily. ----------------- Supplied: Tablet: 12.5 mg, 25 mg, 50 mg |
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Valdecoxib (Bextra ® )
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Relief of signs and symptoms of osteoarthritis and adult rheumatoid
arthritis; treatment of primary dysmenorrhea ----------------- Dosage: Oral: Adults: Osteoarthritis and rheumatoid arthritis: 10 mg once daily; Note: No additional benefits seen with 20 mg/day Primary dysmenorrhea: 20 mg twice daily as needed ----------------- Dosage adjustment in renal impairment: Not recommended for use in advanced disease Dosage adjustment in hepatic impairment: Not recommended for use in advanced liver dysfunction (Child-Pugh Class C) ----------------- Supplied: Tablet: 10 mg, 20 mg |
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Disclaimer |
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Listed dosages are for - Adult patients ONLY. PLEASE READ THE
DISCLAIMER CAREFULLY BEFORE
ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE
TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.
GlobalRPH does not directly or indirectly practice medicine or provide
medical services and therefore assumes no liability whatsoever of any
kind for the information and data accessed through the Service or for
any diagnosis or treatment made in reliance thereon. David F. McAuley, Pharm.D., R.Ph. GlobalRPh Inc. |
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