1998 canadian drug of choice

Drugs of choice [1]
Drug therapy for osteoarthritis is symptom dependent. The use of simple analgesics may be all that is required for the relief of pain in joints.

acetaminophen    650-975 mg, every 4 h prn    $0.14-0.21/day

Second-line therapies
1. As an adjunct to acetaminophen. May also be used with other second-line therapies.
glucosamine [2,3]    500 mg, tid prn    $0.50/day
or capsaicin [4]    0.025% cream, qid prn    $7.80/42.5 g

2. ASA or NSAIDs should be tried only when simple analgesics have failed, as they are generally no more effective than simple analgesics, and they may cause further cartilage damage. Low-dose NSAIDs can also be combined with acetaminophen. [5,6]

ASA, enteric-coated    650 mg, qid prn    $0.10/day
or ibuprofen    300-400 mg, qid prn    $0.11-0.15/day
or naproxen    250-500 mg, bid prn    $0.21-0.42/day
or indomethacin    25-50 mg, tid prn    $0.29-0.50/day

3. Intra-articular corticosteroids, as an alternative to NSAIDs particularly in the elderly [7]

methylprednisolone    4-80 mg, intra-articular, every4 months prn     $0.47-9.00/injection
or triamcinolone    5-40 mg, intra-articular, every4 months prn     $1.46-6.82/injection

Additional instructions and notes
-For osteoarthritis of the knee an aerobic or a resistance exercise program produces modest improvements in measures of disability, physical performance and pain.[9]
-NSAIDs should be avoided in the elderly if possible.
-Reassess NSAIDs after 4-6 weeks of use. If there is no benefit at this time then they should be discontinued.
-There is a tendency to opt for lower dosage schedules of NSAIDs in treating osteoarthritis.