Common Indications Osteoarthritis & rheumatoid arthritis Acute musculoskeletal pain Post-operative pain Dysmenorrhea Migraine (in some formulations) Top Formulations` Oral tablets (immediate & extended-release) Topical gels (great for localized pain with fewer systemic effects) Eye drops (post-cataract surgery inflammation) Injections (acute severe pain) Key Safety Considerations Cardiovascular risk: Increased risk of thrombotic events use lowest effective dose, shortest duration GI toxicity: Ulcers, bleeding consider PPIs in high-risk patients Renal impairment: Can reduce renal blood flow caution in CKD, dehydration, heart failure Hepatotoxicity: Monitor LFTs with long-term use Contraindications: Post-CABG, 3rd trimester pregnancy, aspirin-sensitive asthma Drug Interactions to Watch Anticoagulants ( bleeding risk) ACE inhibitors/ARBs & diuretics ( renal risk) Lithium & methotrexate ( toxicity) Other NSAIDs (additive toxicity) Pro Tips for Practice Topical diclofenac = excellent efficacy with minimal systemic exposure for localized conditions Always screen for CV and GI risk factors before prescribing The 200mg/day ceiling is a good rule of thumb for oral dosing Consider switching to COX-2 selective agents (like celecoxib) in high GI risk, but remember CV risk still exists What's your go-to NSAID
Read our article about semaglutide dosing guidelines to make your weight loss safe
Diabetes & Endocrinology, 10 (6), 418429
For compounded semaglutide with shorter BUDs, this becomes even more important
This approach works for some people but not others, and individual response to dose reduction is difficult to predict in advance
