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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Non-steroidal Anti-inflammatories (NSAIDs)

The MHRA advice regarding the safety of NSAIDs has already been summarised on this site.

The following recommendations apply in relation to the safe prescribing of NSAIDs:

  1. Review the patient for the overall risks involved with NSAID treatment - this should include an assessment of gastro-intestinal risk, cardio-vascular risk, renal risk as well as pre-treatment assessment of blood pressure and renal function. Where possible use Paracetamol based analgesia as first line with a ladder approach if initial analgesia fails.
  2. Where the overall risks are low or NSAID treatment is absolutely necessary despite moderate to high risk, the NSAID of lowest risk should be used at the lowest possible dose and for the shortest possible duration.
  3. This will usually mean that Ibuprofen is the first line NSAID.
  4. If Ibuprofen therapy fails or is not tolerated, re-assess the patient for an NSAID before trying an alternative. Suitable alternatives would include diclofenac and naproxen.

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3 Comments to “Non-steroidal Anti-inflammatories (NSAIDs)”

  1. [...] Action: Based on the increased cost and lack of evidence for superior efficacy over Ibuprofen there is no reason to use this drug before current first choice options of Ibuprofen, Diclofenac and Naproxen as recommended in the Formulary. [...]

    Pingback by Prescribing Advice for GPs » Ibuprofen Isomer — April 25, 2008 #

  2. [...] All NSAID use carries risk, implementing current recommendations ensures this risk is minimised. Copyright ©2006 Prescribing Advice for [...]

    Pingback by Prescribing Advice for GPs » EMEA to update NSAID review — September 27, 2006 #

  3. […] stepped approach to analgesia has already been reported that recommends paracetamol based analgesics first with NSAIDs used where risk is low or use of […]

    Pingback by New Cox-II Inhibitor | Prescribing Advice for GPs — December 14, 2005 #

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