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Nonsteroidal anti-inflammatory drugs, or NSAIDs, are generally effective for mild to moderate pain when used alone. They are sometimes combined with an opioid when stronger pain relief is needed. Some people tolerate NSAIDs quite well, but they can have adverse effects in older people, especially the frail elderly. NSAIDs can cause bleeding in the gastrointestinal tract and can cause ulcers. They can also interfere with certain medications given to lower blood pressure. So before we prescribe an NSAID for one of our residents, we carefully review their medical history and the medications they are currently taking. If there is a history of peptic ulcer or gastrointestinal bleeding, we probably won't want to use an NSAID. If your loved one has a diagnosis of congestive heart failure, high blood pressure, cirrhosis, or has reduced kidney function, another pain medication may be preferable to an NSAID. There is no "best" pain medication for everyone. Determining what is right for each resident is what individualizing therapy is all about.
