Which medications in the drug class Nonsteroidal Anti-inflammatory Drugs (NSAIDs) are used in the treatment of Tenosynovitis?

Updated: Oct 25, 2017
  • Author: Mark R Foster, MD, PhD, FACS; Chief Editor: Harris Gellman, MD  more...
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Answer

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

NSAIDs are most commonly used for the relief of mild to moderate pain. Although the effects of NSAIDs in pain treatment tend to be patient specific, ibuprofen usually is the drug of choice (DOC) for initial therapy. Other options include fenoprofen, flurbiprofen, mefenamic acid, ketoprofen, indomethacin, and piroxicam. NSAIDs are primarily used for de Quervain and volar flexor tenosynovitis.

Ibuprofen (Motrin, Advil, NeoProfen)

This agent inhibits inflammatory reactions and pain, probably by decreasing the activity of the enzyme cyclooxygenase (COX), in this way inhibiting prostaglandin synthesis. Ibuprofen is usually the DOC for the treatment of mild to moderate pain if no contraindications exist.

Naproxen (Anaprox, Naprelan, Naprosyn, Aleve)

Naproxen is used for the relief of mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing the activity of the enzyme COX.

Ketoprofen

Ketoprofen inhibits inflammatory reactions and pain by decreasing the activity of cyclooxygenase, thereby decreasing prostaglandin synthesis. Smaller initial dosages are particularly indicated in elderly patients and in those with renal or liver dysfunction. Doses higher than 75 mg do not improve the therapeutic response and may be associated with a higher incidence of adverse effects.

Meclofenamate

Meclofenamate inhibits inflammatory reactions and pain by decreasing the activity of cyclooxygenase, thereby decreasing prostaglandin synthesis. Compared with other NSAIDs, it is associated with a higher incidence of diarrhea.

Mefenamic acid (Ponstel)

Mefenamic acid inhibits inflammatory reactions and pain by decreasing the activity of cyclooxygenase, thereby decreasing prostaglandin synthesis. Compared with other NSAIDs, it is associated with a higher incidence of diarrhea.

Flurbiprofen

Flurbiprofen may inhibit cyclooxygenase, thereby inhibiting prostaglandin biosynthesis. These effects may result in analgesic, antipyretic, and anti-inflammatory activities.

Fenoprofen (Nalfon)

Fenoprofen decreases the formation of prostaglandin precursors by inhibiting cyclooxygenase 1 and 2 enzymes. It may also inhibit neutrophil aggregation/activation, inhibit chemotaxis, alter lymphocyte activity, and decrease proinflammatory cytokine levels.


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