Pharmacology Notes

No single NSAID has been shown to be generally more effective than any other, but some patients seem to respond better to one than to others. Generally, NSAIDs should be used for the shortest possible time. In chronic pain management, however, it is important to give individual NSAIDs an adequate therapeutic trial of 2 to 4 weeks, as its maximum effect may be delayed.

In general, the less gastrotoxic, shorter-acting drugs should be chosen for preference, and used at the lowest dose consistent with symptom control, and for the shortest possible time. Using a short-acting drug is especially important in the elderly, and in patients with impaired renal function. Issues to consider when prescribing NSAIDs are shown in Box 1.1 below.