Table of Contents
Medications
Acetaminophen
Acetaminophen (Tylenol) is the first choice for treating osteoarthritis. (Acetaminophen may be less effective than NSAIDs in reducing moderate-to-severe pain.) Because acetaminophen has fewer side effects, most doctors suggest trying this drug first, then switching to an NSAID if acetaminophen does not provide sufficient pain relief.
Side Effects. Acetaminophen is inexpensive and generally safe. It poses far less of a risk for gastrointestinal problems than NSAIDs.
It does have some adverse effects, however, and the daily dose should not exceed 4 grams (4,000 mg). Patients who take high doses of this drug for long periods are at risk for liver damage, particularly if they drink alcohol and do not eat regularly.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) block prostaglandins, the substances that dilate blood vessels and cause inflammation and pain. There are dozens of NSAIDs available:
- Over-the-counter NSAIDs NSAIDs include aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), ketoprofen (Actron, Orudis KT).
- Prescription NSAIDs include flurbiprofen (Ansaid), diclofenac (Voltaren, Cataflam), tolmetin (Tolectin), ketoprofen (Orudis, Oruvail), nabumetone (Relafen), dexibuprofen (Seractil), indomethacin (Indocin), meloxicam (Mobic, generic).
- Topical NSAIDs are gels, creams, or patches that are available either by prescription or over-the-counter. It is not clear how effective they are for osteoarthritis.
Oral NSAIDs should be used only for a short period of time. Long-term use of NSAIDs does not delay the progression of osteoarthritis and can increase patients' risk of side effects.
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Review Date: 06/16/2010
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor
of Medicine, Harvard Medical School; Physician, Massachusetts
General Hospital. Also reviewed by David Zieve, MD, MHA, Medical
Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
