Can A Non-Selective NSAID Provide Improved Pain Relief?

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By Anthony Leone, Special Projects Editor

Whether clinicians are combating painful symptoms associated with osteoarthritis or easing the postoperative pain of patients, clinicians have found a key ally with a medication that has been around for 30 years. A non-selective, non-steroidal antiinflammatory drug, Nalfon (fenoprofen) is a proprionic acid derivative that is available in 200 mg, immediate release capsules. Clinicians have written over 37 million prescriptions for Nalfon since its FDA approval in 1976, according to Pedinol, which acquired the drug last year. Nalfon provides mild to moderate pain relief in 15 to 30 minutes for up to four to six hours, notes Bryan Caldwell, DPM, a Professor and Assistant Dean at the Ohio College of Podiatric Medicine. Jeffrey Lucido, DPM, concurs with Dr. Caldwell. In his experience, Dr. Lucido has found that patients taking Nalfon have had a 60 to 80 percent reduction of painful symptoms. What About Postoperative Pain? In a previous “News And Trends” article (see page 10, August 2005 issue), Dr. Caldwell cited studies that suggest 100 mg and 200 mg of Nalfon provide more effective pain relief than 60 mg of codeine. Pedinol says a double-blind study compared codeine and Nalfon in the treatment of postoperative pain. For the study, which involved nearly 400 patients, the participants were given 200 mg of Nalfon, 60 mg of codeine or a placebo. According to Pedinol, the researchers of the study found that Nalfon and codeine were comparable in their analgesic effect and significantly better than the placebo. Dr. Lucido has also found success in utilizing Nalfon to ease postoperative pain. The podiatrist, who is based in Brooklyn, N.Y., says he will start the medication at one week postoperatively to reduce pain and to minimize the amount of controlled substance a patient would use. A Closer Look At Other Uses For Nalfon Nalfon can relieve acute pain that one might experience with fractures and heel spurs as well as chronic pain that is common with rheumatoid arthritis and osteoarthritis, according to Dr. Lucido. Dr. Caldwell adds that higher doses of Nalfon can successfully treat acute gout. Pedinol cites a double-blind study that compared 1200 mg/day of ibuprofen against 1200 mg/day of Nalfon for osteoarthritis. The study of 40 patients found that both pain and functional limitation were improved with both drugs at the end of the 15-day treatment period, according to Pedinol. The company says both drugs were well tolerated in the study. Another double-blind study, involving 77 patients with soft tissue injuries, found that 400 mg of Nalfon three-times-a-day reduced pain, swelling and bruising from these injuries by the seventh day of treatment. Pedinol says the treatments, along with 250 mg of naproxen sodium three-times-a-day, were well tolerated by patients and few drug-related side effects were reported. As with all NSAIDs, Nalfon does have common gastrointestinal side effects, according to Dr. Lucido. However, he says the use of an antacid with the medication does not interfere with the absorption of Nalfon.

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