Arthritis Treatments: NSAIDs

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ARTHRITIS TREATMENTS: NSAIDS
ARTHRITIS TREATMENTS: NSAIDS
Generic Brand Strength Form Usual Dose
ACETIC ACIDS DERIVATIVES
diclofenac potassium 50mg tabs Adults: OA:50mg 2−3 times daily. RA: 50mg 3−4 times daily. 
Children: Not established.
diclofenac sodium 25mg, 50mg, 75mg e-c tabs Adults: OA: 50mg 2−3 times daily or 75mg twice daily. RA: 50mg 3−4 times daily or 75mg twice daily. AS: 25mg 4 times daily, with an additional 25mg at bedtime if necessary.
Children: Not established.
100mg ext‑rel tabs Adults: OA: 100mg once daily. RA: 100mg once daily; rarely 100mg twice daily may be used.
Children: Not established.
Zorvolex 18mg, 35mg caps Adults: ≥18yrs: 35mg three times daily.
Children: <18yrs: not established.
etodolac 200mg, 300mg caps Adults: Initially 300mg 2–3 times daily, or 400mg twice daily, or 500mg twice daily; usual max 1000mg/day in divided doses. May give 600mg once daily for long-term use.
Children: <18yrs: Not established.
400mg, 500mg tabs
400mg, 500mg, 600mg ext‑rel tabs Adults: Initially 400–1000mg once daily.
Children: <6yrs: Not established. Give once daily. JRA: 6–16yrs (20–30kg): 400mg; (31–45kg): 600mg; (46–60kg): 800mg; (>60kg): 1000mg.
indometh-
acin
25mg, 50mg caps Adults: Acute gouty arthritis: 50mg 3 times daily until pain tolerable; then rapidly reduce dose to discontinue. Other conditions: initially 25mg 2−3 times daily. Increase if needed at weekly intervals by 25−50mg daily; max 200mg daily.
Children: ≤14yrs: not established. If risk warranted, monitor and assess liver function periodically. ≥2yrs: 1−2mg/kg/day in divided doses; max 3−4mg/kg/day (or 150−200mg/day whichever is less).
50mg supp
Indocin Susp 25mg/
 
5mL
susp
nabu-
metone
500mg, 750mg tabs Adults: Initially 1g once daily; max 2g/day in 1 or 2 divided doses. Renal insufficiency (CrCl 30−49mL/min): initial max 750mg once daily, may increase to 1.5g/day; (CrCl <30mL/min): initial max 500mg once daily, may increase to 1g/day.
Children: Not recommended.
sulindac 150, 200mg scored tabs Adults: RA, OA, AS: 150mg twice daily. Gouty arthritis: 200mg twice daily, usually for 7–14 days. All: max 400mg/day.
Children: Not established.
COX-2 INHIBITORS
celecoxib Celebrex 50mg, 100mg, 200mg, 400mg caps Adults: ≥18yrs: OA: 200mg once daily or 100mg twice daily. RA: 100−200mg twice daily. AS: 200mg in 1−2 divided doses; if no response after 6wks, 400mg once daily may be tried. <50kg: start at lowest recommended dose.
Children: <2yrs or <10kg: not studied. JRA: ≥2yrs (≥10kg to ≤25kg): 50mg twice daily; (>25kg): 100mg twice daily.
PROPIONIC ACIDS DERIVATIVES
fenoprofen Nalfon 200mg, 400mg caps Adults: 400mg−600mg 3 or 4 times daily. Max: 3.2g/day.
Children: <18yrs: not established.
flurbiprofen 50mg, 100mg tabs Adults: 200−300mg/day in 2−4 divided doses; max single dose 100mg.
Children: Not established.
ibuprofen 400mg, 600mg, 800mg tabs Adults: RA, OA: 400−800mg 3−4 times daily; max 3.2g/day.
Children: JRA: 30−40mg/kg/day in 3−4 doses. May use 20mg/kg/day in 3−4 doses for milder disease.
ketoprofen ext-rel 200mg ext‑rel caps Adults: 200mg daily.
Children: Not recommended.
naproxen Anaprox 275mg tabs Adults: Arthritis, spondylitis: 275mg or 550mg twice daily. Tendinitis, bursitis: Initially 550mg, then 550mg every 12 hrs or 275mg every 6−8hrs; max 1.375g (first day), then max 1.1g/day. Acute gout: 825mg once then 275mg every 8hrs.
Children: <2yrs: not established. ≥2yrs: use susp form of naproxen.
Anaprox
 DS
550mg tabs
Naprelan 375mg, 500mg, 750mg control-
led-rel tabs
Adults: RA, OA, or AS: 750mg−1g once daily; max 1.5g once daily. Acute tendonitis or bursitis: 1g once daily, or 1.5g once daily for a limited period; max 1g/day thereafter. Gout: 1−1.5g once daily for 1 day then 1g once daily until attack subsides.
Children: Not established.
Naprosyn 250mg, 375mg, 500mg tabs Adults: Arthritis, spondylitis: 250−500mg twice daily; max 1.5g/day (up to 6mos). Tendinitis, bursitis: 500mg once, then 500mg twice daily or 250mg every 6−8hrs; max (first day) 1.25g, then max 1g/day. Acute gout: 750mg once, then 250mg every 8hrs.
Children: <2yrs: not established. ≥2yrs: JRA: 5mg/kg twice daily. Other uses: Doses of 2.5−5mg/kg/dose, max 15mg/kg/day have been used.
125mg/
 
5mL
susp
EC-Naprosyn 375mg, 500mg e-c tabs Adults: 375−500mg twice daily.
Children: <18yrs: not studied.
oxaprozin Daypro 600mg scored caplets Adults: RA (≥16yrs) or OA: 1.2 g once daily; max 1.8 g or 26 mg/kg daily, whichever is less, in divided doses. Low body weight, severe renal impairment, or on dialysis: initially 600 mg once daily; max 1.2g daily.
Children: <6yrs: not established. JRA: 6−16yrs (22−31 kg): 600 mg once daily; (32−54 kg): 900 mg once daily; (≥55 kg): 1.2 g once daily.
PROPIONIC ACIDS DERIVATIVE + H2 BLOCKER
ibuprofen + famotidine Duexis* 800mg/
 
26.6mg
tabs Adults: 1 tab three times daily.
Children: Not established.
PROPIONIC ACIDS DERIVATIVE + PROTON PUMP INHIBITOR
naproxen + esomeprazole Vimovo* 375mg/
 
20mg, 500mg/
 
20mg
del-rel tabs Adults: ≥18yrs: one 375mg/20mg or 500mg/20mg tab twice daily.
Children: <12yrs or <38kg: not established. JIA: ≥12yrs (≥38kg–<50kg): one 375mg/20mg tab twice daily; (>50kg): one 375mg/20mg or 500mg/20mg tab twice daily.
OXICAMS DERIVATIVES
meloxicam Mobic 7.5mg, 15mg tabs Adults: ≥18yrs: 7.5mg once daily; max 15mg once daily. Hemodialysis: max 7.5mg/day.
Children: <2yrs or <60kg: not recommended. JRA: ≥2yrs or ≥60kg: 7.5mg once daily.
piroxicam Feldene 10mg, 20mg caps Adults: 20mg daily; may give in 2 divided doses.
Children: Not established.
SALICYLATES
aspirin Bayer 325mg tabs, caplets, gelcaps Adults: RA, arthritis and pleurisy of SLE: initially 3g daily in divided doses; target plasma salicylate level 150−300mcg/mL. OA: up to 3g/day in divided doses. Spondyloarthropathies: up to 4g/day in divided doses.
Children: JRA: initially 90−130mg/kg per day in divided doses; target plasma salicylate level 150−300mcg/mL.
Ecotrin 81mg, 325mg, 500mg e-c tabs
Extra Strength Bayer 500mg caplets, gelcaps
choline magnesium trisalicylate 500mg, 750mg, 1g scored tabs Adults: 3g daily at bedtime or in 2 divided doses.
Elderly: 750mg three times daily.
Children: <12kg: not recommended. 12−37kg: 50mg/kg/day. >37kg: 2.25g/day. Both in 2 divided doses.
500mg/
 
5mL
soln
diflunisal 250mg, 500mg tabs Adults: 250−500mg twice daily; max 1.5g/day.
Children: Not recommended.
salsalate 500mg, 750mg scored tabs Adults: 3g daily in divided doses.
Children: Not recommended.
NOTES

Key: AS = Ankylosing spondylitis; e-c = enteric coated; ext-rel = extended-release; JIA = Juvenile idiopathic arthritis; JRA = Juvenile rheumatoid arthritis; RA = Rheumatoid arthritis; supp = suppositories; susp = suspension; OA = Osteoarthritis

*A fixed-combination tablet indicated for the relief of signs/symptoms of arthritis (eg, RA, OA) and to reduce the risk of developing NSAID-induced GI ulcers.

Not an inclusive list of medications, official indications, and/or dosing details. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

(Rev. 6/2018)

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