[Prescription of non-steroidal anti-inflammatory drugs]

Non steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed and largely used over the counter, especially for analgesic purposes in the most commonly nociceptive painful disorders. Unfortunately, NSAID use is associated with a high rate of side effects which account for 9% to 25% of the reports to the drug surveillance centres all over the world. Interestingly, severe adverse events are partly preventable provided some recommendations are followed. First, individual risk factors (old age, gastrointestinal history, possible drug interaction, ...) should be carefully assessed in order to take particular preventive measures (coprescription of misoprostol or omeprazole, treatment of a preexisting dehydration, ...) or ensure specific monitoring. Second, NSAIDs should be used at the lowest effective dosage after consideration of safer alternatives. Third, NSAIDs should be combined with other analgesics with the aim of reducing NSAID dosage. Finally, the patients should be informed about the main side effects of NSAIDs.