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What are the safety considerations and adverse effects associated with prescribing oral NSAIDs for musculoskeletal pain in patients with comorbidities?
What are the safety considerations and adverse effects associated with prescribing oral NSAIDs for musculoskeletal pain in patients with comorbidities?
Clinicians must carefully consider cardiovascular, gastrointestinal, and renal comorbidities as well as potential drug interactions when prescribing oral NSAIDs for musculoskeletal pain.
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Supports caution with oral NSAIDs in patients with cardiovascular disease; extends evidence on COX selectivity but leaves optimal selection open.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed for the treatment of painful musculoskeletal conditions. When prescribing oral NSAIDs, clinicians must consider coexisting cardiovascular, cerebrovascular, gastrointestinal, and renal disease because oral NSAIDs are associated with a broad spectrum of adverse effects on these systems. The different safety profiles of NSAIDs can be attributed to differences in the extent to which the drug inhibits cyclo-oxygenase-1 vs -2 and their potential for drug-drug interactions. This narrative review intends to guide the clinician in prescribing oral NSAIDs while taking into consideration these comorbid conditions and drug interactions. LEVEL OF EVIDENCE: III.
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Hatt et al. (2018) studied this question.
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