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Forum Name: Pharmacy & Drug Topics
Question: combining meds
|drmajid - Sun Sep 14, 2003 4:12 am|
I aske about the usage of more than one of NSAID'S in the same time :?:
|Dr. Tamer Fouad - Sun Sep 14, 2003 7:22 am|
Please describe more fully the situation in which you are prescribing more than one NSAID at the same time.
|drmajid - Sat Sep 20, 2003 4:15 am|
Thank you Dr.Tamer
For example : Usage Voltarin and Brufen in treatment patient with arthritis.
|Dr. Tamer Fouad - Mon Sep 22, 2003 3:32 pm|
Although there are no drug interactions between the two, they both function in the same way as you well know. They both inhibit prostaglandin synthesis. They also both have similar side effects especially they are both known to be associated with the development of peptic ulcer and git bleeding.
Its a well known principle that its always best to use the smallest dose for the shortest duration when it comes to NSAIDs so as to avoid the side effects. Another thing is that there is nothing that two NSAIDs can do that a larger dose of one of them can't do. Meaning that if the patient is not responding well to one of them then maybe you should increase the dose or better yet shift or add a better drug. If they are being used as anaelgesics then you should maybe check the WHO pain management ladder. Although there is some contraversy around this subject it still gives a good idea of how to proceed for many common pain conditions.
|sisohel - Tue Sep 23, 2003 6:37 pm|
Why not go for a more potent NSAID ie-Tramadol , or increse the dose of volaren with adding prednisolone or aspirin in appopriate doses. Don't forget to give the H2 Blockers as it prevents PUD.
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