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Things I Do, But Should I? Celecoxib

Adrien Selim, MD and Vanessa Cardy, MD
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Are COX-2 inhibitors a good NSAID choice for elderly patients with pain issues? Sometimes yes and sometimes no. In a new recurring segment, Vanessa Cardy and Adrian Selim explore GI, renal, and cardiovascular risks of selective and nonselective NSAIDs.

 

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Robert S., MD -

I was hoping that there would be some comment about not using an NSAID at all, since most of the things that NSAID's are use for (osteoarthritis) have little or no inflammation. Acetaminophen would be safer than both the NSAID's and the cox-2 agents and often just as effective.

Vanessa C. -

I certainly agree that acetaminophen would be the safer way to go, but it certainly does happen that acetaminophen doesn't quite cut and then you have to look at other options.

Adrien Selim -

Hi Robert, thanks for your comment. I agree with you 100%: we don't use acetaminophen as much as we should and rely on NSAIDs far too often. A good dose of acetaminophen goes a long way (not the 325mg every other day which is too often the case).

Having said that, there are several situations where an NSAID course would be warranted. For example, an acute MSK injury, inflammatory arthritis, nephrolithiasis, etc.

I hope that clarifies...

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