NSAIDs

  • CAUTION: Gastro-intestinal ADRs (Risk factors: age>75, GI ulcer, antithrombotics, steroids, SSRIs, high alcohol use)
    • If NSAIDs are essential: Consider gastro-protection with a PPI in those with GI risk factors
  • CAUTION: Cardiovascular ADRs (Risk factors: CVD risk>20%, previous CVD events, heart failure)
  • CAUTION: Renal ADRs (Risk factors: age>65, on ACEI, ARBs and/or diuretics, CKD or heart failure
    • If NSAIDs are essential: Monitor eGFR; advise patient to stop during intercurrent illness

Safety

Skeletal muscle relaxants

Rarely indicated long term (except for spasticity)

Need

CAUTION: Anticholinergic ADRs

Safety

DMARDs

Assess effectiveness and discuss any need for changes with secondary care specialist

Effectiveness

Ensure patient adherence to dosing/monitoring regimen

Adherence/Patient centeredness

CAUTION: Methotrexate overdosing. Avoid preparations with different strengths

Safety