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PM R. 2018 Dec;10(12):1404-1411. doi: 10.1016/j.pmrj.2018.06.011. Epub 2018 Jun 30.

Safety Considerations in Prescription of NSAIDs for Musculoskeletal Pain: A Narrative Review.

Author information

1
Department of Physical Medicine and Rehabilitation, Lewis Katz School of Medicine, Temple University, 3401 North Broad St, Philadelphia, PA 19140; Department of Physical Medicine and Rehabilitation, MossRehab, Elkins Park, PA(∗). Electronic address: katie.hatt@tuhs.temple.edu.
2
Department of Physical Medicine and Rehabilitation, Lewis Katz School of Medicine Temple University, Philadelphia, PA; Department of Physical Medicine and Rehabilitation, MossRehab, Elkins Park, PA(†).
3
Department of Physical Medicine and Rehabilitation, Lewis Katz School of Medicine Temple University, Philadelphia, PA, USA(‡).
4
Department of Physical Medicine and Rehabilitation, Lewis Katz School of Medicine Temple University, Philadelphia, PA, USA(§).

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed for the treatment of painful musculoskeletal conditions. When prescribing oral NSAIDs, clinicians must consider coexisting cardiovascular, cerebrovascular, gastrointestinal, and renal disease because oral NSAIDs are associated with a broad spectrum of adverse effects on these systems. The different safety profiles of NSAIDs can be attributed to differences in the extent to which the drug inhibits cyclo-oxygenase-1 vs -2 and their potential for drug-drug interactions. This narrative review intends to guide the clinician in prescribing oral NSAIDs while taking into consideration these comorbid conditions and drug interactions. LEVEL OF EVIDENCE: III.

PMID:
29964214
DOI:
10.1016/j.pmrj.2018.06.011

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