Table 6 Guideline recommendations for medication
AAOS [10] | EULAR [6] | ICSI [9] | Schnitzer/ACR [7] | CCC [8] | |
|---|---|---|---|---|---|
Nonselective NSAID | Recommended (A) | Recommended (A) | Recommended if acetaminophen not effective | Recommended | Recommended (A) |
Recommended with PPI if gastrointestinal risk factors | Recommended with PPI or misoprol if gastrointestinal risk factors | Recommended (A) with PPI if gastrointestinal risk factors | |||
Use with caution for patients with high risk factors for congestive heart failure or renal problems | Use with caution with elderly patients (C) or patients with renal problems (D) | ||||
Not recommended for patients on anticoagulation therapy or preoperative period | |||||
Topical NSAID | Recommended (A) | Recommended (A) | |||
Acetaminophen | Recommended (A) | Recommended (A) as initial pain treatment | Recommended as initial pain treatment | Recommended as initial pain treatment | Recommended (A) as initial pain treatment |
Coxibs | Recommended (B) if renal or gastrointestinal risk factors | Recommended (A) if gastrointestinal risk factors | Recommended if gastrointestinal risk factors | Recommended for patients not responding to acetaminophen or nonpharmacologic modalities | Recommended (A) if gastrointestinal risk factors, depending on cardiovascular risks |
Recommended for patients with severe pain or signs of inflammation | Use with caution with elderly patients (C) or patients with renal problems (D) | ||||
Recommended for patients with high gastrointestinal risks. | |||||
Use with caution for patients with high risk factors for congestive heart failure or renal problems | |||||
Tramadol | Recommended for patients with contraindication to NSAIDs/coxibs or who have not responded to oral therapy | ||||
Opioids | Recommended (B) if NSAIDs are contraindicated | Recommended if NSAIDs contraindicated and if nonpharmacologic treatments not effective | Recommended for patients who have not responded to tramadol or have side effects | ||
Capsaicin | Recommended (A) | Recommended as an adjunct treatment to oral therapy, for patients with contraindication to NSAIDs/coxibs or for patients who have not responded to oral therapy | |||
Nonacetylated salicylates | Recommended | ||||
Methylsalicylate | Recommended as an adjunct treatment to oral therapy, for patients with contraindication to NSAIDs/coxibs or for patients who have not responded to oral therapy |