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What You Should Know About Nonselective NSAIDs
Nonselective NSAIDs can be categorized into five clinically relevant groups: arylpropionic acids, alkanones, heteraryl acetic acids, enolic acids and indole acetic acids (see “A Guide To Non-Selective NSAIDs” below). Dr. Caldwell notes it is useful to know the different categories.
If one drug fails in a particular patient, he says clinicians can choose an NSAID from a different group.
When it comes to the arylpropionic acids, Dr. Caldwell notes fenoprofen is a propionic acid that provides relief from mild to moderate pain within 15 to 30 minutes, and sustains this effect for four to six hours. He cites earlier studies that suggest 100 mg and 200 mg of fenoprofen provide more effective pain relief than 60 mg of codeine, and adds that higher doses can successfully treat acute gout.
Nabumetone, the only NSAID in the alkanone group, is a non-acidic NSAID. While this drug may be of merit for patients with gastrointestinal (GI) upset, Dr. Caldwell says it does not have any protective effect on the stomach. Since nabumetone blocks COX-1, he notes gastric ulcers may still be an occasional problem.