NSAIDs for systemic JIA
Management of systemic juvenile idiopathic arthritis (JIA), and the role of NSAIDs in it, is described in Management for systemic JIA. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used first line to help manage mild systemic features (eg a mild fever) and are also useful for relieving joint pain and stiffness associated with arthritis.
All of the NSAIDs listed below are equally effective and drug choice should be based on patient factors (eg comorbidities), available formulations, and ability to dose around daily schedule. Give:
1celecoxib 2 to 4 mg/kg (for overweight children, use ideal body weight) up to 100 mg orally, twice daily until symptoms subside1 celecoxib celecoxib celecoxib
OR
1diclofenac 1 to 1.5 mg/kg (for overweight children, use ideal body weight) up to 75 mg orally, twice daily until symptoms subside1 diclofenac diclofenac diclofenac
OR
1ibuprofen immediate-release 5 to 10 mg/kg (for overweight children, use ideal body weight) up to 400 mg orally, 3 times daily until symptoms subside2 ibuprofen ibuprofen ibuprofen
OR
1indometacin 0.5 to 1 mg/kg (for overweight children, use ideal body weight) up to 50 mg orally, 2 or 3 times daily until symptoms subside1 indometacin indometacin indometacin
OR
1meloxicam 0.125 mg/kg (for overweight children, use ideal body weight) up to 15 mg orally, daily until symptoms subside1 meloxicam meloxicam meloxicam
OR
1naproxen immediate-release 5 to 7.5 mg/kg (for overweight children, use ideal body weight) up to 500 mg orally, twice daily until symptoms subside3 naproxen naproxen naproxen
OR
1naproxen modified-release (child 50 kg or heavier) 750 to 1000 mg orally, daily until symptoms subside naproxen naproxen naproxen
OR
1piroxicam 0.2 to 0.4 mg/kg (for overweight children, use ideal body weight) up to 20 mg orally, daily until symptoms subside4. piroxicam piroxicam piroxicam