NSAIDs for peripheral psoriatic arthritis
Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in managing the symptoms of pain and inflammation in peripheral psoriatic arthritis. All of the NSAIDs listed below are equally effective and drug choice should be based on patient factors (eg comorbidities); see Choosing an NSAID for advice on drug choice. For relief of pain and inflammation associated with peripheral psoriatic arthritis, use:
1celecoxib 100 to 200 mg orally, daily in 1 or 2 divided doses, until symptoms subside celecoxib celecoxib celecoxib
OR
1etoricoxib 30 to 60 mg orally, daily until symptoms subside etoricoxib etoricoxib etoricoxib
OR
1ibuprofen immediate-release 200 to 400 mg orally, 3 or 4 times daily until symptoms subside ibuprofen ibuprofen ibuprofen
OR
1indometacin 25 to 50 mg orally, 2 to 4 times daily until symptoms subside indometacin indometacin indometacin
OR
1ketoprofen modified-release 200 mg orally, daily until symptoms subside ketoprofen ketoprofen ketoprofen
OR
1meloxicam 7.5 to 15 mg orally, daily until symptoms subside meloxicam meloxicam meloxicam
OR
1naproxen immediate-release 250 to 500 mg orally, twice daily until symptoms subside naproxen naproxen naproxen
OR
1naproxen modified-release 750 to 1000 mg orally, daily until symptoms subside naproxen naproxen naproxen
OR
1piroxicam 10 to 20 mg orally, daily until symptoms subside piroxicam piroxicam piroxicam
OR
2diclofenac 25 to 50 mg orally, 2 or 3 times daily until symptoms subside. diclofenac diclofenac diclofenac
People who suffer from pain throughout the night and stiffness in the morning may find a rectal NSAID improves their sleep quality. If a rectal NSAID is preferred, use:
1indometacin 100 mg rectally, once or twice daily indometacin indometacin indometacin
OR
2diclofenac 25 to 50 mg rectally, 2 or 3 times daily. diclofenac diclofenac diclofenac
The potential benefits of an NSAID should be weighed against its potential harms, particularly in people at high risk of harms (see Principles of NSAID use for musculoskeletal pain for more information).