Medication | Contraindications | Potential adverse effects |
Intraarticular glucocorticoids* |
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Systemic glucocorticoids¶ |
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NSAIDsΔ |
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Colchicine |
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Anti-interleukin 1 (IL-1) therapy (eg, anakinra, canakinumab)¥ |
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eGFR: estimated glomerular filtration rate; NSAID: nonsteroidal antiinflammatory drug.
* Refer to UpToDate content on complications of joint aspiration and injection in adults.
¶ Risk of potential adverse effects depends on dosing and duration. Refer to UpToDate content on adverse effects of systemic glucocorticoids.
Δ Refer to UpToDate content on adverse effects of NSAIDs.
◊ Risk factors include expectation of a prolonged treatment course (eg, crystalline arthropathy flare lasting >48 hours), history of peptic ulcer or gastrointestinal bleeding, age >65 years, and concurrent use of aspirin or glucocorticoids. Refer to UpToDate content on primary and secondary prevention of gastroduodenal toxicity in patients taking NSAIDs.
§ Medications include strong inhibitors of cytochrome P450 3A4 and inhibitors of the P-glycoprotein multidrug resistance transporter. Refer to UpToDate content on the treatment of gout flares for examples.
¥ Refer to UpToDate content on overview of biologic agents in the rheumatic diseases.Do you want to add Medilib to your home screen?