Any diseases of rheumatic joints are accompanied by an inflammatory process, which leads to the appearance of pain, complicating life and impeding movement. Therefore, doctors necessarily include anti-inflammatory drugs in therapy. Among them, non-steroids with the short name NPVS deserve special attention. What is it and how to use it?
What are nonsteroidal anti-inflammatory drugs?
The effect on inflammation in these drugs is manifested in a decrease in fever and pain relief through inhibition of a number of enzymes, and the severity depends on the specific element and its concentration. Despite such a powerful action, they have nothing to do with glucocorticoids (steroid hormones), which is why they got this name.
- When inflammation occurs in the tissues, prostaglandins form, which cause swelling, pain and hyperemia. Nonsteroids slow down their synthesis, thereby reducing inflammation and its attendant symptoms, as well as reduce blood viscosity and its coagulation.
In addition to the use of nonsteroidal drugs for the treatment of joints, they are also used to relieve headache (if it is a migraine), any pain syndromes caused by injuries or operations, as well as bone metastases. Even some of the non-steroids for external use are comparable in strength to analgesics, if we consider their ability to relieve pain.
- The doctor often prescribes nonsteroids by practical selection, since in general they act in the same way and the only thing that determines the result is the individual perception of the active component. The patient is offered a drug from any group of NSAIDs, but at a very low dosage, after which the response of the body is monitored. If the medication has no effect, the next group and its representative are selected.
Before considering the list of nonsteroidal anti-inflammatory drugs, as well as their main groups, it is necessary to familiarize yourself with the contraindications and possible risks, since even drugs for external use are not completely safe because of their penetration into the blood.
- Prolonged oral intake of NSAIDs is prohibited even to a healthy organism, since it has a negative effect on the mucous membrane of the digestive tract and the liver. If there are problems with these organs, especially gastritis and peptic ulcer, internal use of NSAIDs is unacceptable.
- Ointments for the treatment of joints should be used with caution for violations of the liver and kidneys, can not be included in the treatment of pregnant and lactating women.
- When used orally, NSAIDs are not allowed to take alcohol, and tablets can only be taken with clean water.
- In therapy for the treatment of joints more than 1 nonsteroidal drug cannot be used, since this will not have a positive effect on the course of the disease, but will enhance the manifestations of adverse reactions and toxic effects on the body.
Regardless of the method of use of the drug (externally or orally), carefully read the instructions and recommendations of the doctor, do not self-medicate.
Nonsteroidal anti-inflammatory drugs new generation
They differ from their predecessors not so much by their effectiveness as by the reduced degree of impact on the mucous membrane of the digestive tract and cartilage tissue, which makes them safer. The effect on the inflammatory enzymes of cyclooxygenase has become more active, while the effect on the protective enzyme has decreased. It’s not yet as great as its predecessors, but they all give a good result.
The most famous is Movalis. The active substance is a derivative of eolic acid, meloxicam. Movalis is available without a prescription. The price of ampoules is in the range of 650-700 rubles. for 3 pcs., tablets - 800 rubles. for 20 pcs.
- The drug is presented in several forms, the choice depends on the patient's condition. During exacerbation, intramuscular injections are necessary — they are mainly prescribed for rheumatoid arthritis, ankylosing spondylitis and osteoarthritis.
- The effect of the injections is long, therefore they are placed 1-2 times a day. The maximum daily dose for any form of the drug is 15 mg, one-time - 7.5 mg. Children under 15 and pregnant women are not allowed to take the drug.
- In the chronic course of therapy is carried out using suppositories or tablets. Oral administration is carried out with meals.
- Analogs with the same active substance can be produced under the names of Melox, Melbek, Movasin, Mesipol, Artrozan.
Nimesulide is a preparation based on the active ingredient of the same name, is available in the form of tablets, suspensions or gels. In tablets of 50 or 100 mg of the active substance, in a suspension of -10 mg per 1 ml, the gel has a 1% concentration.
- The drug can be used even in pediatric therapy, but only in a suspension format. Indications for use in adults are diseases of the musculoskeletal system and trauma, as well as fever and ENT diseases. The gel is used not only to treat joints, but also to repair ligaments, muscles and tendons.
- For tablets, the daily dosage should not exceed 200 mg, one-time -100 mg. The gel is applied to clean, dry skin with a thin layer, repeating the procedure up to 4 times a day.
- The number of side effects in Nimesulide is minimal, contraindications are only liver and kidney diseases, peptic ulcer.
A large group was also formed by oxycama preparations, from which the new generation nonsteroid lineup began. They have a longer half-life, as a result of which the effect of the use of the drug also increases in duration. Accordingly, the drug can be taken only 1 time per day, which reduces the likelihood of adverse reactions and their intensity.
- Piroxicam. The maximum daily dose is 20 mg, the reception is carried out once a day. In the format of the gel can be used up to 4 times a day.
- Meloxicam. The maximum daily dose is 15 mg.
- Lornoxicam. The maximum daily dose - 32 mg, recommended -16 mg, divided into 2 doses.
- Teneksikam. The maximum daily dose is 20 mg, to maintain -10 mg.
Among the positive aspects of oxycam can be called and the lack of habituation and effects on the central nervous system, anesthetic effect lasts about 12 hours, so re-admission on the same day may not be needed. A significant drawback of this type of drugs is their high cost. Piroksikam packaging (as the most famous and affordable) in capsules is 60 rubles. However, Meloxicam tablets already cost 250 rubles, and its derivative Amelotex in ampoules is 400 rubles.
Nonsteroidal anti-inflammatory ointment for the treatment of joints
Most of the above drugs were focused on oral administration or intramuscular administration, which increased the list of contraindications to them. Safer, according to doctors, are medicines for external use - ointments and gels. Among non-steroids, this is Nimesulide, Amelotex (Meloxicam), which has already been considered. Almost any of the drugs you can find a form for external use. We offer to get acquainted with the most effective.
- Voltaren. The active substance is diclofenac. The maximum daily dose is 200 mg, one-time -100 mg. It is recommended to apply every 6-12 hours. Available in the form of ointment, gel and cream. Prohibited for use in children under 6 years of age, at the last term of pregnancy and during lactation, in patients with impaired blood clotting. The course of treatment should not exceed 14 days. The cost of the tube is in the range of 100-170 rubles.
- Nurofen. Ointment based on propionic acid derivative, suitable for persons suffering from dyspepsia. Contraindications concern only peptic ulcers and cirrhosis of the liver, among the adverse reactions only allergic skin manifestations. External application is possible up to 4 times a day, the ointment is applied with a thin layer, rubbing into the skin. Perhaps its inclusion in therapy against osteochondrosis. Cost - from 100 to 180 rubles.
- Amelotex. It is produced in the gel format, belongs to the group of oxycams, is not absorbed in the systemic circulation, binding to blood proteins. Mainly used to eliminate pain in osteoarthritis. Not allowed for use in areas with skin lesions in pregnant and lactating women. Externally, the gel is used no more than 2 times a day, the course lasts up to 28 days. The cost of the tube - 260-290 rubles.
- Indovazin. The combined drug on the basis of indomethacin and troxeturin, is available in the form of a gel. In addition to inflammation in the joints, it can affect varicose veins, trophic disorders in the vessels, hematomas. Not used in children under 14 years of age, pregnant and lactating women. Applying the gel to the skin - up to 2 times a day, for 10 days. The cost is 280 rubles.
- Ketonal The active substance is ketoprofen, does not affect the cartilage tissue. Mainly used to relieve inflammation in diseases of the musculoskeletal tract, as well as sprains, muscles and tendons. Cream or gel is applied to the skin no more than 3 times a day, the treatment lasts up to 14 days. It is forbidden to hit ultraviolet light on the treated areas.
In conclusion, it is worth mentioning that non-steroidal anti-inflammatory drugs do not have a therapeutic effect - they stop pain and fever, hyperemia, improve the general condition of a person, but do not affect the cause of the disease. For this reason, therapy for the treatment of joints should not be limited to nonsteroids and should not be based on them.