Arthritis Treatments: NSAIDs

Arthritis Treatments: NSAIDS ARTHRITIS TREATMENTS: NSAIDS

ARTHRITIS TREATMENTS: NSAIDS
Generic	Brand	Strength	Form	Usual Dose
ACETIC ACIDS DERIVATIVES
diclofenac potassium	—	50mg	tabs	Adults: OA:50mg 2−3 times daily. RA: 50mg 3−4 times daily. Children: Not established.
diclofenac sodium	—	25mg, 50mg, 75mg	e-c tabs	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 established.
diclofenac sodium		100mg	ext‑rel tabs	Adults: OA: 100mg once daily. RA: 100mg once daily; rarely 100mg twice daily may be used. Children: Not established.
etodolac	—	200mg, 300mg	caps	Adults: Initially 300mg 2–3 times daily, or 400mg twice daily, or 500mg twice daily; usual max 1000mg/day in divided doses. May give 600mg once daily for long-term use. Children: <18yrs: Not established.
		400mg, 500mg	tabs
		400mg, 500mg, 600mg	ext‑rel tabs	Adults: Initially 400–1000mg once daily. Children: <6yrs: Not established. Give once daily. JRA: 6–16yrs (20–30kg): 400mg; (31–45kg): 600mg; (46–60kg): 800mg; (>60kg): 1000mg.
indometh– acin	—	25mg, 50mg	caps	Adults: RA, OA, AS: Initially 25mg 2–3 times daily. Increase if needed at weekly intervals by 25–50mg daily; max 200mg daily. Acute gouty arthritis: 50mg 3 times daily until pain tolerable; then rapidly reduce dose to discontinue. Children: ≤14yrs: not established. If risk warranted, monitor and assess liver function periodically. ≥2yrs: 1−2mg/kg/day in divided doses; max 3−4mg/kg/day (or 150−200mg/day whichever is less).
	—	50mg	rectal supp
	Indocin	25mg/ 5mL	susp
nabu– metone	—	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	—	150, 200mg	scored tabs	Adults: RA, OA, AS: 150mg twice daily. Gouty arthritis: 200mg twice daily, usually for 7–14 days. All: max 400mg/day. Children: Not established.
COX-2 INHIBITORS
celecoxib	Celebrex	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 6wks, 400mg once daily may be tried. <50kg: start at lowest recommended dose. Children: <2yrs or <10kg: not studied. JRA: ≥2yrs (≥10kg to ≤25kg): 50mg twice daily; (>25kg): 100mg twice daily.
PROPIONIC ACIDS DERIVATIVES
fenoprofen	Nalfon	200mg, 400mg	caps	Adults: 400mg−600mg 3 or 4 times daily. Max: 3.2g/day. Children: <18yrs: not established.
flurbiprofen	—	100mg	tabs	Adults: 200−300mg/day in 2−4 divided doses; max single dose 100mg. Children: Not established.
ibuprofen	—	400mg, 600mg, 800mg	tabs	Adults: RA, OA: 400−800mg 3−4 times daily; max 3.2g/day. Children: JRA: 30−40mg/kg/day in 3−4 doses. May use 20mg/kg/day in 3−4 doses for milder disease.
ketoprofen	—	200mg	ext‑rel caps	Adults: 200mg daily. Children: Not recommended.
naproxen	Anaprox DS	550mg	scored tabs	Adults: Arthritis, spondylitis: 275mg or 550mg twice daily. Tendinitis, bursitis: Initially 550mg, then 550mg every 12 hrs or 275mg every 6−8hrs; max 1.375g (first day), then max 1.1g/day. Acute gout: 825mg once then 275mg every 8hrs. Children: <2yrs: not established. ≥2yrs: use susp form of naproxen.
	Naprelan	375mg, 500mg, 750mg	control– led-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 established.
	Naprosyn	500mg	scored tabs	Adults: Arthritis, spondylitis: 250−500mg twice daily; max 1.5g/day (up to 6mos). Tendinitis, bursitis: 500mg once, then 500mg twice daily or 250mg every 6−8hrs; max (first day) 1.25g, then max 1g/day. Acute gout: 750mg once, then 250mg every 8hrs. Children: <2yrs: not established. ≥2yrs: JIA: 5mg/kg twice daily. Other uses: Doses of 2.5−5mg/kg/dose, max 15mg/kg/day have been used.
	Naprosyn	125mg/ 5mL	susp
	EC-Naprosyn	375mg, 500mg	e-c tabs	Adults: 375−500mg twice daily. Children: <18yrs: not studied.
oxaprozin	Daypro	600mg	scored caplets	Adults: RA (≥16yrs) 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, severe renal impairment, or on dialysis: initially 600 mg once daily; max 1.2g daily. Children: <6yrs: not established. JRA: 6−16yrs (22−31 kg): 600 mg once daily; (32−54 kg): 900 mg once daily; (≥55 kg): 1.2 g once daily.
PROPIONIC ACIDS DERIVATIVE + H₂ BLOCKER
ibuprofen + famotidine	Duexis*	800mg/ 26.6mg	tabs	Adults: 1 tab three times daily. Children: Not established.
PROPIONIC ACIDS DERIVATIVE + PROTON PUMP INHIBITOR
naproxen + esomeprazole	Vimovo*	375mg/ 20mg, 500mg/ 20mg	del-rel tabs	Adults: ≥18yrs: one 375mg/20mg or 500mg/20mg tab twice daily. Children: <12yrs or <38kg: not established. JIA: ≥12yrs (≥38kg–<50kg): one 375mg/20mg tab twice daily; (>50kg): one 375mg/20mg or 500mg/20mg tab twice daily.
OXICAMS DERIVATIVES
meloxicam	Mobic	7.5mg, 15mg	tabs	Adults: ≥18yrs: 7.5mg once daily; max 15mg once daily. Hemodialysis: max 7.5mg/day. Children: <2yrs or <60kg: not recommended. JRA: ≥2yrs or ≥60kg: 7.5mg once daily.
meloxicam	Mobic
piroxicam	Feldene	10mg, 20mg	caps	Adults: 20mg daily; may give in 2 divided doses. Children: Not established.
SALICYLATES
aspirin	Bayer	325mg	tabs, caplets, gelcaps	Adults: RA, arthritis and pleurisy of SLE: initially 3g daily in divided doses; target plasma salicylate level 150−300mcg/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 150−300mcg/mL.
	Ecotrin	81mg, 325mg	e-c tabs
	Extra Strength Bayer	500mg	caplets, gelcaps
	Vazalore	81mg, 325mg	liquid-filled caps	Adults: RA, arthritis and pleurisy of SLE: initially 3g daily in divided doses; target plasma salicylate level 150–300mcg/mL. OA: up to 3g/day in divided doses. Spondyloarthropathies: up to 4g/day in divided doses. Children: JRA: initially 90–130mg/kg/day in divided doses; target plasma salicylate level 150–300mcg/mL.
diflunisal	—	250mg, 500mg	tabs	Adults: 250−500mg twice daily; max 1.5g/day. Children: Not recommended.
salsalate	—	500mg, 750mg	scored tabs	Adults: 3g daily in divided doses. Children: Not recommended.
salsalate	—	NOTES
Key: AS = Ankylosing spondylitis; e-c = enteric coated; ext-rel = extended-release; JIA = Juvenile idiopathic arthritis; JRA = Juvenile rheumatoid arthritis; RA = Rheumatoid arthritis; supp = suppositories; susp = suspension; OA = Osteoarthritis *A fixed-combination tablet indicated for the relief of signs/symptoms of arthritis (eg, RA, OA) and to reduce the risk of developing NSAID-induced GI ulcers. Not an inclusive list of medications, official indications, and/or dosing details. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling. (Rev. 4/2023)

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