C H A P T E R 1 6
Anti-inflammatory, antiarthritis and related agents
247
TABLE 16.2
DRUGS IN FOCUS Non-steroidal anti-inflammatory drugs (NSAIDs) and related agents
Drug name
Dosage/route
Usual indications
NSAIDs
Propionic acids
flurbiprofen (Ocufen,
Strepfen)
Ophthalmic solution: 1 drop (gtt) q 30 minutes
beginning 2 hours after surgery
Lozenge: dissolve one loz every 3–6 hours
Long-term management of arthritis;
topically to manage pain after eye surgery
in adults; relief of severe sore throat
ibuprofen (Advil,
Brufen, others)
Adult: 400–800 mg PO t.d.s. to q.i.d.
Paediatric: 30–40 mg/kg per day PO in three to
four divided doses for arthritis; 5–10 mg/kg
PO q 6–8 hours for fever
Treatment of pain, arthritis,
dysmenorrhoea, juvenile arthritis
ketoprofen (Orudis)
100–200 mg PO/day or one suppository
rectally at night
Short-term management of pain; long-
term management of arthritis (SR form);
ophthalmic form to relieve ocular itching
naproxen (Naprosyn)
Adult: 250–500 mg PO b.d.; do not give
>200 mg q 12 hours for geriatric people
Paediatric: 10 mg/kg per day PO in two
divided doses for juvenile arthritis; do not
give OTC versions to children <12 years
without consulting healthcare provider
Treatment of pain, arthritis,
dysmenorrhoea, juvenile arthritis
tiaprofenic acid (Surgam)
Adult: 300–600 mg PO daily
Management of rheumatoid arthritis and
osteoarthritis
Acetic acids
diclofenac (Voltaren,
Clonac, Dinac)
75–150 mg/day PO or PR
Treatment of acute and chronic pain
associated with inflammatory conditions
in adults
indomethacin (Arthrexin,
Indocin)
50–200 mg/day PO or PR. PDA in premature
neonate: 0.1–0.25 mg/kg q 12–24 hours ×
three doses
Relief of moderate to severe pain in PO,
topical and PR forms; closure of patent
ductus arteriosus in premature infants
(given IV)
ketorolac (Toradol)
10 mg PO q 4–6 hours, or 30–60 mg IM,
switching to oral form as soon as possible, or
30 mg IV as a single dose
Ophthalmic: 1 gtt to affected eye q.i.d.; reduce
dose with renal impairment and in people
>65 years
Short-term management of pain in adults;
topically to relieve ocular itching
sulindac (Aclin)
150–200 mg PO b.d.
Treatment of various inflammatory
conditions in adults
Fenamates
mefenamic acid (Ponstan)
500 mg PO, then 250 mg PO q 6 hours as
needed
Short-term treatment of pain in adults
and children >14 years; primary
dysmenorrhoea
Oxicam derivative
meloxicam (Mobic)
Adult: 7.5 mg/day PO to a maximum of
15 mg/day
Paediatric: 0.125 mg/kg per day PO to a
maximum of 7.5 mg/day
Treatment of osteoarthritis, rheumatoid
arthritis and juvenile arthritis
piroxicam (Feldene)
20 mg/day PO as a single dose
Treatment of acute and chronic arthritis in
adults
Cyclooxygenase-2 inhibitors
celecoxib (Celebrex)
Initially: 100–200 mg PO b.d.; acute pain
400 mg PO then 200 mg PO b.d. for familial
adenomatous polyposis (FAP)
Treatment of acute and chronic
arthritis in adults; acute pain; primary
dysmenorrhoea; reduction of the number
of colorectal polyps in FAP; ankylosing
spondylitis
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