Last updated on November 27, 2019 at 13:42
The analgetic and antiinflammatory effects of different NSAIDs are very similar. Some patients respond better to some NSAIDs than others.
|NSAID||Special features||Special indications|
|Naproxen||Less cardiovascular risk, strong plasma protein binding|
|Ibuprofen||Less GI, renal, cardiovascular (?) side effect risk, strong plasma protein binding|
|Diclofenac||Accumulates in synovial fluid, higher cardiovascular risk||Rheumatoid arthritis|
|Indomethacin||Inhibits phagocytosis of urate crystals||Gout|
COX2-preferential and COX2-specific NSAIDs
These drugs have an important benefit over traditional NSAIDs; they cause minimal gastrointestinal side effects.
All orally, except parecoxib which is IV.
- Same as for non-selective NSAIDs, but preferred in people with:
- Peptic ulcer
- Platelet disorders
- Aspirin asthma
- Unique indications
- Prevention of colorectal cancer in famillial adenomatous polyposis
- Sulpha drug allergy
These drugs are sulpha drugs, so they should be used carefully in people with allergy to other sulpha drugs.
- No antiplatelet effect
- Minimal GI side effects
- No aspirin asthma
- Same as for non-selective NSAIDs:
- Decreased renal function
- Cardiovascular side effects
It was previously believed that COX2-selective NSAIDs produced more cardiovascular side effects than the non-selective ones, but recently that has been disproved. Both types cause similar risk for cardiovascular side effects.
28. Non-steroidal antiinflammatory drugs. Aspirin, paracetamol
30. Adjuvant analgesics. Drugs used to treat gout. Centrally-acting muscle relaxants