Median Neuropathy Medication

Updated: Oct 27, 2014
  • Author: Friedhelm Sandbrink, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Medication

Medication Summary

Nonsteroidal anti-inflammatory medications (NSAIDs) are frequently prescribed for this condition; caution patients to watch for the usual adverse effects. Short-term diuretic treatment may be helpful in patients with limb swelling. A study by Chang et al in patients with mild-to-moderate CTS found that short-term, low-dose oral steroid treatment (prednisolone, 20 mg qd x 2 wk, then 10 mg qd x 2 wk) was more effective than treatment with a diuretic or an NSAID. [53] A follow-up study found that 2 weeks of prednisolone provided long-term results comparable to those with 4 weeks of treatment. [54]

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Nonsteroidal anti-inflammatory drugs (NSAIDs)

Class Summary

These agents have analgesic and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell-membrane functions. Various NSAIDs may be used.

Naproxen (Anaprox, Naprelan, Naprosyn)

For relief of mild to moderately severe pain; inhibits inflammatory reactions and pain by decreasing activity of cyclooxygenase, which is responsible for prostaglandin synthesis.

Ibuprofen (Ibuprin, Advil, Motrin)

DOC for mild to moderately severe pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Ketoprofen (Oruvail, Orudis, Actron)

For relief of mild to moderately severe pain and inflammation. Small dosages indicated initially in patients with small body size, the elderly, and those with renal or liver disease.

Doses >75 mg do not increase therapeutic effects.

Administer high doses with caution and closely observe patient for response.

Flurbiprofen (Ansaid)

May inhibit cyclooxygenase, which in turn inhibits prostaglandin biosynthesis. These effects may result in analgesic, antipyretic, and anti-inflammatory activities.

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Corticosteroid agents

Class Summary

A recent report suggested that short-term oral steroids may be beneficial in CTS.

Prednisolone (AK-Pred, Delta-Cortef, Articulose-50, Econopred)

Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reducing capillary permeability.

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