Meniscal Injury Medication

Updated: Nov 19, 2021
  • Author: Sarjoo M Bhagia, MD; Chief Editor: Ryan O Stephenson, DO  more...
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Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.



Class Summary

Pain control is essential to quality patient care. Analgesics ensure patient comfort and have sedating properties, which are beneficial for patients who have sustained injuries.

Acetaminophen (Tylenol, Feverall, Tempra, Aspirin-Free Anacin)

DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, with upper GI disease, or who are taking oral anticoagulants.


Nonsteroidal anti-inflammatory drugs

Class Summary

Have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase (COX) 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.

Ibuprofen (Motrin, Ibuprin)

DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Naproxen (Naprelan, Anaprox, Naprosyn)

For relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing activity of COX, which results in a decrease of prostaglandin synthesis.

Diclofenac (Voltaren, Cataflam)

Designated chemically as 2-[(2,6-dichlorophenyl)amino] benzeneacetic acid, monosodium salt, with an empirical formula of C14 H10 Cl2 NO2 NA. One of a series of phenylacetic acids that has demonstrated anti-inflammatory and analgesic properties in pharmacological studies. Believed to inhibit COX, which is essential in biosynthesis of prostaglandins. Can cause hepatotoxicity; hence, monitor liver enzyme levels in first 8 wk of treatment.

Rapidly absorbed; metabolism occurs in liver by demethylation, deacetylation, and glucuronide conjugation. Delayed-release, enteric-coated form is diclofenac sodium, and immediate release form is diclofenac potassium. Has relatively low risk for bleeding GI ulcers.

Celecoxib (Celebrex)

Primarily inhibits COX-2. COX-2 is considered an inducible isoenzyme, induced during pain and by inflammatory stimuli. Inhibition of COX-1 may contribute to NSAID GI toxicity. At therapeutic concentrations, COX-1 isoenzyme is not inhibited, thus GI toxicity may be decreased. Seek lowest dose of celecoxib for each patient.


Narcotic analgesics

Class Summary

Narcotic analgesics should be used sparingly in the conservative treatment period. The use of these agents is warranted only in special cases in which intolerable pain is present that cannot be controlled by first-line medications. However, these drugs are commonly used in the postoperative period when surgical treatment is necessary. Many options are available, and narcotic analgesics are commonly combined with drugs from the above categories. Common examples are listed.

Hydrocodone and acetaminophen (Vicodin, Lortab, Lorcet)

Drug combination for moderate to severe pain.

Oxycodone (OxyIR, OxyContin, Roxicodone)

Indicated for moderate to severe pain.