Matching articles for "Osteoarthritis"
Nonopioid Drugs for Pain
The Medical Letter on Drugs and Therapeutics • March 7, 2022; (Issue 1645)
Nonopioid drugs can be used in the treatment of
many nociceptive and neuropathic pain conditions.
For severe pain, especially severe chronic cancer
pain, use of opioids may be necessary....
Nonopioid drugs can be used in the treatment of
many nociceptive and neuropathic pain conditions.
For severe pain, especially severe chronic cancer
pain, use of opioids may be necessary. Noninvasive
nonpharmacologic treatments, including physical
and psychological therapies, have been shown to
improve pain and function in patients with some
common chronic pain conditions and are unlikely
to cause serious harms. A multimodal approach to
analgesic therapy can increase pain control while
reducing opioid use and adverse effects.
Drugs for Osteoarthritis
The Medical Letter on Drugs and Therapeutics • April 20, 2020; (Issue 1596)
Many different drugs are used for treatment of
osteoarthritis pain, but none of them prevent
progression of the disease. Nonpharmacologic
approaches including weight management, exercise,
tai chi, physical...
Many different drugs are used for treatment of
osteoarthritis pain, but none of them prevent
progression of the disease. Nonpharmacologic
approaches including weight management, exercise,
tai chi, physical therapy, assistive devices, and total
joint arthroplasty can also be used. The American
College of Rheumatology (ACR) has published new
guidelines for the management of osteoarthritis of the
hip, hand, and knee.
Turmeric Supplements
The Medical Letter on Drugs and Therapeutics • November 18, 2019; (Issue 1585)
Turmeric is a spice derived from the Curcuma longa
plant. Dietary supplements and foods containing
turmeric are widely promoted for relief of pain
and to improve joint mobility, immunity,...
Turmeric is a spice derived from the Curcuma longa
plant. Dietary supplements and foods containing
turmeric are widely promoted for relief of pain
and to improve joint mobility, immunity, digestion,
cardiovascular health, depression, anxiety, memory,
and cognition.
Qmiiz ODT - An Orally Disintegrating Meloxicam Tablet
The Medical Letter on Drugs and Therapeutics • September 23, 2019; (Issue 1581)
The FDA has approved Qmiiz ODT (TerSera), an orally
disintegrating tablet formulation of the prescription
NSAID meloxicam. Qmiiz ODT, like conventional oral
meloxicam tablets (Mobic, and generics), is...
The FDA has approved Qmiiz ODT (TerSera), an orally
disintegrating tablet formulation of the prescription
NSAID meloxicam. Qmiiz ODT, like conventional oral
meloxicam tablets (Mobic, and generics), is indicated
for relief of the symptoms of osteoarthritis (OA) and
rheumatoid arthritis (RA) in adults and of juvenile RA
in children who weigh ≥60 kg. Vivlodex, a low-dose
capsule formulation of meloxicam, is FDA-approved
only for management of OA pain.
Two New Intra-Articular Injections for Knee Osteoarthritis
The Medical Letter on Drugs and Therapeutics • August 27, 2018; (Issue 1554)
The FDA has approved a single-injection hyaluronic
acid gel (Durolane – Bioventus) and an extended-release
(ER) formulation of the synthetic corticosteroid
triamcinolone acetonide (Zilretta – Flexion)...
The FDA has approved a single-injection hyaluronic
acid gel (Durolane – Bioventus) and an extended-release
(ER) formulation of the synthetic corticosteroid
triamcinolone acetonide (Zilretta – Flexion) for intra-articular
(IA) treatment of osteoarthritic knee pain.
Comparison Table: Some Nonopioid Analgesics for Pain (online only)
The Medical Letter on Drugs and Therapeutics • February 12, 2018; (Issue 1540)
...
View the Comparison Table: Some Nonopioid Analgesics for Pain
Celecoxib Safety Revisited
The Medical Letter on Drugs and Therapeutics • December 19, 2016; (Issue 1510)
The results of a clinical trial (PRECISION) comparing
the cardiovascular safety of the COX-2 selective
NSAID celecoxib (Celebrex, and generics) with that
of ibuprofen and naproxen, which are...
The results of a clinical trial (PRECISION) comparing
the cardiovascular safety of the COX-2 selective
NSAID celecoxib (Celebrex, and generics) with that
of ibuprofen and naproxen, which are nonselective,
have been described in the lay press in terms that may
overestimate the safety of celecoxib.
Low-Dose Meloxicam (Vivlodex) for Osteoarthritis Pain
The Medical Letter on Drugs and Therapeutics • March 14, 2016; (Issue 1490)
The FDA has approved Vivlodex (Iroko), a low-dose
formulation of the nonsteroidal anti-inflammatory drug
meloxicam (Mobic, and generics), for management of
osteoarthritis pain. According to the manufacturer,...
The FDA has approved Vivlodex (Iroko), a low-dose
formulation of the nonsteroidal anti-inflammatory drug
meloxicam (Mobic, and generics), for management of
osteoarthritis pain. According to the manufacturer, the
new formulation aligns with stronger FDA warnings
about the cardiovascular risks of NSAIDs and the
recommendation to use the lowest possible doses of
these drugs.
Drugs for Osteoarthritis
The Medical Letter on Drugs and Therapeutics • September 1, 2014; (Issue 1450)
Many different drugs are used for treatment of osteoarthritis
pain, but none of them prevent progression
of the disease. Many nonpharmacologic approaches
are available as well, including weight...
Many different drugs are used for treatment of osteoarthritis
pain, but none of them prevent progression
of the disease. Many nonpharmacologic approaches
are available as well, including weight management,
exercise, physical therapy, assistive devices, and total
joint arthroplasty. New guidelines for the management
of osteoarthritis have recently been published.
Low-Dose Diclofenac (Zorvolex) for Pain
The Medical Letter on Drugs and Therapeutics • March 3, 2014; (Issue 1437)
The FDA has approved Zorvolex (Iroko), a low-dose
oral formulation of the relatively COX-2 selective NSAID
diclofenac, for treatment of mild-to-moderate acute pain
in...
The FDA has approved Zorvolex (Iroko), a low-dose
oral formulation of the relatively COX-2 selective NSAID
diclofenac, for treatment of mild-to-moderate acute pain
in adults.
A Fixed-Dose Combination of Ibuprofen and Famotidine (Duexis)
The Medical Letter on Drugs and Therapeutics • October 31, 2011; (Issue 1376)
The FDA has approved Duexis (Horizon), a fixed-dose
combination of the nonsteroidal anti-inflammatory drug
(NSAID) ibuprofen and the H2-receptor antagonist
(H2RA) famotidine, for symptomatic relief of...
The FDA has approved Duexis (Horizon), a fixed-dose
combination of the nonsteroidal anti-inflammatory drug
(NSAID) ibuprofen and the H2-receptor antagonist
(H2RA) famotidine, for symptomatic relief of osteoarthritis
and rheumatoid arthritis and to decrease the risk of
developing gastric and duodenal ulcers in patients at
risk for NSAID-associated ulcers. Vimovo, a combination
of the NSAID naproxen and the proton pump
inhibitor (PPI) esomeprazole, is also approved by the
FDA for prevention of NSAID-associated gastric ulcers.
Duloxetine (Cymbalta) for Chronic Musculoskeletal Pain
The Medical Letter on Drugs and Therapeutics • May 2, 2011; (Issue 1363)
Previously approved by the FDA for treatment of depression, general anxiety disorder, diabetic peripheral
neuropathic pain and fibromyalgia, duloxetine (Cymbalta – Lilly) has now also been approved...
Previously approved by the FDA for treatment of depression, general anxiety disorder, diabetic peripheral
neuropathic pain and fibromyalgia, duloxetine (Cymbalta – Lilly) has now also been approved for
treatment of chronic musculoskeletal pain.
In Brief: Does Acetaminophen Increase Blood Pressure?
The Medical Letter on Drugs and Therapeutics • April 18, 2011; (Issue 1362)
A recent article in Circulation reported that acetaminophen (Tylenol, and others; paracetamol outside the US) increased blood pressure in patients with coronary artery disease. This conclusion was based on a...
A recent article in Circulation reported that acetaminophen (Tylenol, and others; paracetamol outside the US) increased blood pressure in patients with coronary artery disease. This conclusion was based on a randomized, placebo-controlled crossover trial in 33 patients; acetaminophen 1 g three times daily for 2 weeks was associated with statistically significant increases in blood pressure of 2.9 mmHg systolic and 2.2 mmHg diastolic.1
NSAIDs can increase blood pressure; the mechanism is thought to be inhibition of cyclooxygenase leading to decreased renal prostaglandin activity. Acetaminophen also inhibits cyclooxygenase (primarily COX-2) and decreases prostaglandin activity.2
The small increases in blood pressure reported with acetaminophen would probably be inconsequential in low-risk patients, but might be a concern for those with cardiovascular disease. Like most drugs, acetaminophen should be used in the lowest effective doses for the shortest possible time. Mild to moderate pain due to osteoarthritis or headache generally responds to a dose of 650 mg.3
1. I Sudano et al. Acetaminophen increases blood pressure in patients with coronary artery disease. Circulation 2010; 122:1789.
2. B Hinz et al. Acetaminophen (paracetamol) is a selective cyclooxygenase-2 inhibitor in man. FASEB J 2008; 22:383.
3. Drugs for pain. Treat Guidel Med Lett 2010; 8:25.
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NSAIDs can increase blood pressure; the mechanism is thought to be inhibition of cyclooxygenase leading to decreased renal prostaglandin activity. Acetaminophen also inhibits cyclooxygenase (primarily COX-2) and decreases prostaglandin activity.2
The small increases in blood pressure reported with acetaminophen would probably be inconsequential in low-risk patients, but might be a concern for those with cardiovascular disease. Like most drugs, acetaminophen should be used in the lowest effective doses for the shortest possible time. Mild to moderate pain due to osteoarthritis or headache generally responds to a dose of 650 mg.3
1. I Sudano et al. Acetaminophen increases blood pressure in patients with coronary artery disease. Circulation 2010; 122:1789.
2. B Hinz et al. Acetaminophen (paracetamol) is a selective cyclooxygenase-2 inhibitor in man. FASEB J 2008; 22:383.
3. Drugs for pain. Treat Guidel Med Lett 2010; 8:25.
Download U.S. English
Naproxen/Esomeprazole (Vimovo)
The Medical Letter on Drugs and Therapeutics • September 20, 2010; (Issue 1347)
The FDA has approved the marketing of Vimovo
(AstraZeneca), a fixed-dose combination of the nonsteroidal
anti-inflammatory drug (NSAID) naproxen
and the proton pump inhibitor (PPI) esomeprazole,...
The FDA has approved the marketing of Vimovo
(AstraZeneca), a fixed-dose combination of the nonsteroidal
anti-inflammatory drug (NSAID) naproxen
and the proton pump inhibitor (PPI) esomeprazole, for
symptomatic relief of osteoarthritis, rheumatoid arthritis
and ankylosing spondylitis and to decrease the risk
of developing gastric ulcers in patients at risk for
NSAID-associated ulcers.
Acetaminophen Safety - Deja Vu
The Medical Letter on Drugs and Therapeutics • July 13, 2009; (Issue 1316)
Concerns have surfaced again at the FDA and in the media about the safety of acetaminophen and the multiplicity of products on the market in the US that contain various amounts of...
Concerns have surfaced again at the FDA and in the media about the safety of acetaminophen and the multiplicity of products on the market in the US that contain various amounts of it.
Diclofenac Gel For Osteoarthritis
The Medical Letter on Drugs and Therapeutics • April 21, 2008; (Issue 1284)
The nonsteroidal anti-inflammatory drug (NSAID) diclofenac, has been approved by the FDA in a 1% topical gel formulation (Voltaren Gel - Endo) for treatment of osteoarthritis (OA). A 3% topical diclofenac gel...
The nonsteroidal anti-inflammatory drug (NSAID) diclofenac, has been approved by the FDA in a 1% topical gel formulation (Voltaren Gel - Endo) for treatment of osteoarthritis (OA). A 3% topical diclofenac gel (Solaraze) is currently approved for treatment of actinic keratoses, but not for topical use on joints. No other topical NSAIDs are approved by the FDA for OA. A diclofenac patch (Flector) was recently approved by the FDA for treatment of pain due to minor strains, sprains and contusions.
Acupuncture
The Medical Letter on Drugs and Therapeutics • May 8, 2006; (Issue 1234)
Acupuncture is the practice of inserting fine needles for therapeutic purposes into points on the skin known as acupoints. In traditional Chinese medicine theory, these points arefound along channels that...
Acupuncture is the practice of inserting fine needles for therapeutic purposes into points on the skin known as acupoints. In traditional Chinese medicine theory, these points arefound along channels that conduct "qi" (pronounced "chee"), or energy. In addition to insertion of needles, acupoints can be stimulated by heat, electrical current or just pressure.
Intra-Articular Injections for Osteoarthritis of the Knee
The Medical Letter on Drugs and Therapeutics • March 27, 2006; (Issue 1231)
Now that glucosamine and chondroitin, 2 favorite over-the-counter remedies for painful osteoarthritis (OA) of the knee, have been at least somewhat discredited, some patients will be asking about alternatives....
Now that glucosamine and chondroitin, 2 favorite over-the-counter remedies for painful osteoarthritis (OA) of the knee, have been at least somewhat discredited, some patients will be asking about alternatives. One of these is periodic intra-articular injection of a corticosteroid or hyaluronic acid preparation.
NSAID Alternatives
The Medical Letter on Drugs and Therapeutics • January 17, 2005; (Issue 1200)
Patients taking nonsteroidal anti-inflammatory drugs (NSAIDs) may be asking their health care providers if they should continue, and some may be asking for alternatives. For most patients taking nonspecific...
Patients taking nonsteroidal anti-inflammatory drugs (NSAIDs) may be asking their health care providers if they should continue, and some may be asking for alternatives. For most patients taking nonspecific NSAIDs, it would be reasonable to continue. For those who are taking the COX-2 selective celecoxib (Celebrex) because they cannot tolerate the gastrointestinal (GI) effects of nonspecific NSAIDs, it seems reasonable to continue at doses no higher than 100 mg b.i.d. or 200 mg once daily; at these dosages cardiovascular risk has been no higher than with placebo. All NSAIDs, including COX-2 inhibitors, can decrease renal blood flow and cause fluid retention, hypertension and renal failure, especially in the elderly and in patients who take diuretics. The unpublished study that led to an FDA alert on an increased cardiovascular risk with naproxen (Naprosyn, and others) was conducted in patients older than 70. See NSAID addendum
Valdecoxib (Bextra) - a New Cyclooxygenase-2 Inhibitor
The Medical Letter on Drugs and Therapeutics • April 29, 2002; (Issue 1129)
Valdecoxib (Bextra - Pharmacia/Pfizer), a selective cyclooxygenase (COX-2) inhibitor similar to celecoxib (Celebrex) and rofecoxib (Vioxx), was recently approved by the FDA for treatment of osteoarthritis,...
Valdecoxib (Bextra - Pharmacia/Pfizer), a selective cyclooxygenase (COX-2) inhibitor similar to celecoxib (Celebrex) and rofecoxib (Vioxx), was recently approved by the FDA for treatment of osteoarthritis, rheumatoid arthritis and primary dysmenorrhea.
Meloxicam (Mobic) for Osteoarthritis
The Medical Letter on Drugs and Therapeutics • May 29, 2000; (Issue 1079)
Meloxicam, a nonsteroidal anti-inflammatory drug (NSAID) with some cyclooxygenase-2 (COX-2) selectivity in vitro, has been approved by the FDA for treatment of...
Meloxicam, a nonsteroidal anti-inflammatory drug (NSAID) with some cyclooxygenase-2 (COX-2) selectivity in vitro, has been approved by the FDA for treatment of osteoarthritis.
Rofecoxib for Osteoarthritis and Pain
The Medical Letter on Drugs and Therapeutics • July 2, 1999; (Issue 1056)
Rofecoxib, a selective COX-2 inhibitor, has been approved by the FDA for treatment of osteoarthritis, acute pain and menstrual...
Rofecoxib, a selective COX-2 inhibitor, has been approved by the FDA for treatment of osteoarthritis, acute pain and menstrual pain.
Nabumetone - A New Nsaid
The Medical Letter on Drugs and Therapeutics • April 17, 1992; (Issue 868)
Nabumetone (Relafen - SmithKline Beecham), a new nonsteroidal anti-inflammatory drug (NSAID), has been approved by the US Food and Drug Administration for treatment of rheumatoid arthritis and osteoarthritis....
Nabumetone (Relafen - SmithKline Beecham), a new nonsteroidal anti-inflammatory drug (NSAID), has been approved by the US Food and Drug Administration for treatment of rheumatoid arthritis and osteoarthritis. The drug has been available in the United Kingdom since 1987. The manufacturer claims that nabumetone is as effective as other NSAIDs and causes a relatively low incidence of peptic ulcers.
Etodolac
The Medical Letter on Drugs and Therapeutics • August 23, 1991; (Issue 851)
Etodolac (Lodine - Wyeth-Ayerst), a nonsteroidal anti-inflammatory drug (NSAID) available in Europe for several years, was recently approved by the U.S. Food and Drug Administration for use in osteoarthritis...
Etodolac (Lodine - Wyeth-Ayerst), a nonsteroidal anti-inflammatory drug (NSAID) available in Europe for several years, was recently approved by the U.S. Food and Drug Administration for use in osteoarthritis and as a general-purpose analgesic. It has not been approved for treatment of rheumatoid arthritis.
Flurbiprofen
The Medical Letter on Drugs and Therapeutics • April 7, 1989; (Issue 789)
Flurbiprofen (Ansaid - Upjohn), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1977, was recently approved by the US Food and Drug Administration for treatment of rheumatoid...
Flurbiprofen (Ansaid - Upjohn), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1977, was recently approved by the US Food and Drug Administration for treatment of rheumatoid arthritis and osteoarthritis. Flurbiprofen is a fluorinated phenylalkanoic acid derivative structurally related to ibuprofen (Motrin;and others).
Diclofenac
The Medical Letter on Drugs and Therapeutics • December 2, 1988; (Issue 780)
Diclofenac sodium (Voltaren - Geigy), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1974, was recently introduced in the USA for treatment of rheumatoid arthritis,...
Diclofenac sodium (Voltaren - Geigy), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1974, was recently introduced in the USA for treatment of rheumatoid arthritis, osteoarthritis and ankylosing spondylitis. It is being promoted as 'The number one prescribed antiarthritic in the world.'