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Musculoskeletal
Generic Name | Brand Name | Pharmacologic Category | Common Indications | Key Side Effects/Other Notes | US Boxed Warning | US Boxed Warning Cont. | US Boxed Warning Cont. |
---|---|---|---|---|---|---|---|
tizanidine (PO) | Zanaflex | Alpha2 agonist | Spasticity | Key Side Effects: drowsiness, hypotension, dizziness, xerostomia, weakness | |||
hydroxychloroquine (PO) | Plaquenil | Aminoquinolone | RA, SLE, malaria | Key Side Effects: retinal toxicity, rash, diarrhea Other Notes: use has been associated with cardiomyopathy, bone marrow suppression, and neuromuscular effects (i.e., myopathy, palsies, and progressive weakness) | |||
colchicine (PO) | Colcrys | Antigout agent | Gout | Key Side Effects: diarrhea, nausea, vomiting, bone marrow suppression, myopathy (including rhabdomyolysis | |||
diclofenac (PO) | Voltaren | NSAID | OA, RA, acute pain | Key Side Effects: diarrhea, dyspepsia, abdominal pain, flatulence, nausea Other Notes: may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | US Boxed Warning: may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; | US Boxed Warning: ....... may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation | |
ibuprofen (PO) * | Motrin, Advil | NSAID | OA, RA, acute pain | Key Side Effects: diarrhea, dyspepsia, abdominal pain, flatulence, nausea Other Notes: may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | US Boxed Warning: may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; | US Boxed Warning: ....... may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation | |
meloxicam (PO) | Mobic | NSAID | OA, RA, acute pain | Key Side Effects: diarrhea, dyspepsia, abdominal pain, flatulence, nausea Other Notes: may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | US Boxed Warning: may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; | US Boxed Warning: ....... may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation | |
indomethacin (PO) | Indocin | NSAID | OA, RA, acute pain, gout | Key Side Effects: diarrhea, dyspepsia, abdominal pain, flatulence, nausea Other Notes: may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | US Boxed Warning: may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; | US Boxed Warning: ....... may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation | |
naproxen (PO) * | Naprosyn, Anaprox, Aleve | NSAID | OA, RA, acute pain, gout | Key Side Effects: diarrhea, dyspepsia, abdominal pain, flatulence, nausea Other Notes: may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | US Boxed Warning: may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; | US Boxed Warning: ....... may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation | |
ketorolac (PO, IV) | Toradol | NSAID | Pain | Key Side Effects: diarrhea, dyspepsia, abdominal pain, flatulence, nausea Other Notes: may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | US Boxed Warning: may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; | US Boxed Warning: ....... may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation | US Boxed Warning (only for ketorolac) indicated for short term use (≤ 5 days) |
celecoxib (PO) | Celebrex | NSAID, COX-2 selective | OA, RA, acute pain | Key Side Effects: diarrhea, dyspepsia, abdominal pain, flatulence, nausea Other Notes: may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | US Boxed Warning: may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; | US Boxed Warning: ....... may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation | |
diclofenac (topical) * | Voltaren Gel | NSAID | OA | Key Side Effects: pruritus, rash | |||
cyclobenzaprine (PO) | Flexeril | Skeletal muscle relaxant | Muscle spasm | Key Side Effects: drowsiness, dizziness, xerostomia, fatigue Other Notes: use may cause prolonged cardiac arrhythmias, and tachycardia; CI within 14 days of MAOI inhibitor therapy | |||
baclofen (PO) | ------- | Skeletal muscle relaxant | Spasticity | Key Side Effects: drowsiness Other Notes: drug abuse potential (carisoprodol only) | |||
carisoprodol (PO) | Soma | Skeletal muscle relaxant | Muscle spasm | Key Side Effects: drowsiness Other Notes: drug abuse potential (carisoprodol only) | |||
methocarbamol (PO) | Robaxin | Skeletal muscle relaxant | Muscle spasm | Key Side Effects: drowsiness Other Notes: drug abuse potential (carisoprodol only) | |||
metaxalone (PO) | Skelaxin | Skeletal muscle relaxant | Muscle spasm | Key Side Effects: drowsiness Other Notes: drug abuse potential (carisoprodol only) | |||
lidocaine (transdermal *, IV) | Transdermal: Lidoderm, IV: Xylocaine | Transdermal: topical analgesic IV: antiarrhythmic | Transdermal: pain, IV: ventricular arrhythmias | Key Side Effects (transdermal): dermatitis, erythema, urticaria, skin depigmentation, skin edema Key Side Effects (IV) bradycardia Other Notes: patch may remain in place for up to 12 hours in any 24-hour period, patch may be cut | |||
allopurinol (PO) | Zyloprim | Xanthine oxidase Inhibitor | Gout | Key Side Effects: diarrhea, nausea, rash, leukopenia, thrombocytopenia Other Notes: rare association with severe (and potentially fatal) allopurinol hypersensitivity syndrome (risk highest in certain Asian populations) | |||
succinylcholine (IV) | Anectine | Depolarizing neuromuscular blocking agent | Neuromuscular blockade for intubation or procedures | Key Side Effects: hyperkalemia, myalgia, malignant hyperthermia (rare) | US Boxed Warning: acute rhabdomyolysis and hyperkalemia leading to cardiac arrest and death in pediatric patients with undiagnosed skeletal muscle disease |