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E-DRUG: NSAIDs

Dear Rodolfo,

For recommendations on the rational use of NSAIDs you do not have to 
go very far. There is an excellent short list in the standard therapy 
textbook (Conn 1995):
1. Choose a nonsalicylate NSAID
2. Prescribe full dose
3. Do NOT use combinations of NSAIDs
4. Use time-release formulations or suppository to treat night pain 
and morning stiffness
5. Trial period for a NSAID is 2 to 3 weeks minimum
6. Switch to another NSAID if previous response is suboptimal
7. Add cytoprotective agent if there is a high risk of ulcer
8. Allow reduction or cessation of therapy after several months to 
determine efficacy of current NSAID
9. Educate patient about the benefits and potential risks of NSAIDs

Best wishes,

Leo Offerhaus MD PhD, clinical pharmacologist, past regional adviser 
pharmaceuticals WHO Europe.


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