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THEY SAID WHICH NSAID?

Writer's picture: Concise Curated CounsellingConcise Curated Counselling

Common does not necessarily mean optimal as we will see today!

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1. Counselling Conundrum: a real question from a patient

2. Concise Conclusion: a straight-forward patient-friendly answer

3. Quick Wrap-up

Clearly, there are nuances that may not be captured in this format. The goal here is to provide you with helpful counselling tips which often draw from multiple sources or those which are not commonly accessed by busy healthcare providers serving the community.


Counselling Conundrum: "I am having a gout flare, and I was taking ibuprofen but my Doctor told me he would give me something better, and gave me this prescription (hands prescription for indomethacin). What do you think?"

Concise Conclusion: Well, indomethacin will work for your gout, and it is definitely more commonly prescribed for this condition. That being said, there is no good reason to prefer it over ibuprofen at equivalent doses given that they are both medications in the same family and therefore work similarly.

Quick Wrap-up: This misconception is still rampant today, likely due to it's historical use in gout. However, there is currently no evidence that we could find suggesting one NSAID is more efficacious than another, specifically for gout. In terms of safety, available evidence actually points towards ibuprofen, naproxen, and celecoxib. Our go-to in most cases is naproxen as indomethacin seems to carry higher gastrointestinal risk, and ibuprofen seems to cause more hypertension than naproxen and celecoxib. Of course, celecoxib is a great choice if prioritizing gastrointestinal risk over cardiovascular risk.

Dive Deeper

We hope you have found this useful. Would appreciate your reply to this email with any feedback or topic suggestions you can; it will be the key to making this newsletter the best it can be.

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