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Guideline recommendations for medication |
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| AAOS [10] |
EULAR [6] |
ICSI [9] |
Schnitzer/ACR [7] |
CCC [8] |
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|
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| Nonselective NSAID |
Recommended (A) |
Recommended (A) |
Recommended if acetaminophen not effective |
Recommended |
Recommended (A) |
| Recommended with PPI if gastrointestinal risk factors |
Recommended with PPI or misoprol if gastrointestinal risk factors |
Recommended (A) with PPI if gastrointestinal risk factors |
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| Use with caution for patients with high risk factors for congestive heart failure or renal problems |
Use with caution with elderly patients (C) or patients with renal problems (D) |
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| Not recommended for patients on anticoagulation therapy or preoperative period |
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| Topical NSAID |
Recommended (A) |
Recommended (A) |
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| Acetaminophen |
Recommended (A) |
Recommended (A) as initial pain treatment |
Recommended as initial pain treatment |
Recommended as initial pain treatment |
Recommended (A) as initial pain treatment |
| Coxibs |
Recommended (B) if renal or gastrointestinal risk factors |
Recommended (A) if gastrointestinal risk factors |
Recommended if gastrointestinal risk factors |
Recommended for patients not responding to acetaminophen or nonpharmacologic modalities |
Recommended (A) if gastrointestinal risk factors, depending on cardiovascular risks |
| Recommended for patients with severe pain or signs of inflammation |
Use with caution with elderly patients (C) or patients with renal problems (D) |
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| Recommended for patients with high gastrointestinal risks. |
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| Use with caution for patients with high risk factors for congestive heart failure or renal problems |
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| Tramadol |
Recommended for patients with contraindication to NSAIDs/coxibs or who have not responded to oral therapy |
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| Opioids |
Recommended (B) if NSAIDs are contraindicated |
Recommended if NSAIDs contraindicated and if nonpharmacologic treatments not effective |
Recommended for patients who have not responded to tramadol or have side effects |
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| Capsaicin |
Recommended (A) |
Recommended as an adjunct treatment to oral therapy, for patients with contraindication to NSAIDs/coxibs or for patients who have not responded to oral therapy |
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| Nonacetylated salicylates |
Recommended |
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| Methylsalicylate |
Recommended as an adjunct treatment to oral therapy, for patients with contraindication to NSAIDs/coxibs or for patients who have not responded to oral therapy |
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AAOS, American Academy of Orthopaedic Surgeons; ACR, American College of Rheumatology; CCC, Canadian Consensus Conference; EULAR, European League Against Rheumatism; ICSI, Institute for Clinical Systems Improvement; NSAID, nonsteroidal anti-inflammatory drug; PPI, proton pump inhibitor. | |||||
Poitras et al. Arthritis Research & Therapy 2007 9:R126 doi:10.1186/ar2339 |
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