Meniscus Injuries Medication

Updated: Oct 12, 2018
  • Author: Bradley S Baker, MD; Chief Editor: Craig C Young, MD  more...
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Medication

Medication Summary

Medical therapy is used in the treatment of meniscal injuries. It can be used during trials of nonoperative management with associated rest, ice, and a rehabilitation program. If surgical treatment is indicated, medical therapy is valuable in postoperative management.

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Nonsteroidal anti-inflammatory drugs

Class Summary

NSAIDs are a first-line medical therapy. The goal with the use of these agents is to reduce pain and inflammation during early attempts at conservative management of meniscal tears or during the postoperative period following surgical treatment. Myriad drugs are available. A few are listed below, including the newer cyclooxygenase (COX)-2 inhibitors. The COX-2 inhibitors are more specifically directed at inflammation and pain without the gastrointestinal (GI) toxicity.

Ibuprofen (Motrin, Ibuprin)

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

Celecoxib (Celebrex)

Inhibits primarily COX-2, which is considered an inducible isoenzyme; induced during pain and 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 for each patient.

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Analgesics

Class Summary

Analgesics are an alternative therapy to NSAIDs with similar indications. These agents are directed primarily at controlling pain and do not have an anti-inflammatory effect.

Acetaminophen (Tylenol, Feverall, 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.

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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 the first-line drugs. 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, Norcet)

Drug combination for moderate to severe pain.

Oxycodone (Roxicodone, OxyContin, OxyIR)

Indicated for moderate to severe pain.

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