Iliopsoas Tendinitis Medication

Updated: Jan 16, 2019
  • Author: Joseph P Garry, MD, FACSM, FAAFP; Chief Editor: Sherwin SW Ho, MD  more...
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Medication

Medication Summary

The drugs of choice for treatment of iliopsoas tendonitis and most other tendinopathies are NSAIDs. This class of drugs provides good analgesia and possible anti-inflammatory properties.

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Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Class Summary

This class of drugs has analgesic and antipyretic activities and possibly also anti-inflammatory activities. Their mechanism of action is not known, but they may inhibit COX activity and prostaglandin synthesis. Other mechanisms may also exist, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.

Ibuprofen (Addaprin, Advil, Motrin, Caldolor, Provil)

DOC for mild to moderate pain. May inhibit inflammatory reactions and pain by decreasing prostaglandin synthesis. Ibuprofen is a low-cost medication.

Naproxen (Anaprox, Naprelan, Naprosyn, Aleve)

For relief of mild to moderate pain; may inhibit inflammatory reactions and pain by decreasing activity of COX, which is responsible for prostaglandin synthesis. May demonstrate superior analgesic properties compared to ibuprofen.

Diclofenac (Cambia, Zipsor, Dyloject, Zorvolex)

Diclofenac inhibits prostaglandin synthesis by decreasing COX activity, which, in turn, decreases formation of prostaglandin precursors.

Indomethacin (Indocin, Tivorbex)

Indomethacin is used for relief of mild to moderate pain; it inhibits inflammatory reactions and pain by decreasing the activity of COX, which results in a decrease of prostaglandin synthesis.

Ketoprofen (Active-Ketoprophen)

Ketoprofen is used for relief of mild to moderate pain and inflammation. Small dosages are indicated initially in small patients, elderly patients, and patients with renal or liver disease. Doses higher than 75 mg do not increase the therapeutic effects. Administer high doses with caution, and closely observe the patient’s response.

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Cyclooxygenase-2 (COX-2) Inhibitors

Class Summary

Cox-2 inhibitors operate as non-steroidal anti-inflammatory drugs with the potential for less fatal GI bleeding due to ulceration and possibly enhanced analgesic properties. Ongoing analysis of cost avoidance of GI bleeds will further define the populations that will find COX-2 inhibitors the most beneficial.

Celecoxib (Celebrex)

Inhibits primarily COX-2. COX-2 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 of celecoxib for each patient. Provides good analgesia with potential for less GI toxicity.

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Analgesics

Class Summary

Useful for patients in whom NSAIDs are contraindicated. Analgesics are potentially useful for patients who require a more prolonged use of analgesics.

Acetaminophen (Tylenol, Acephen, Cetafen, Q-Pap, 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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