Published online Dec 11, 2018. doi: 10.5499/wjr.v8.i1.1
Peer-review started: May 18, 2018
First decision: June 14, 2018
Revised: November 15, 2018
Accepted: November 29, 2018
Article in press: November 29, 2018
Published online: December 11, 2018
Non-steroidal anti-inflammatory drugs have a fundamental and pivotal position in management of many of the disorders managed by rheumatologists. Promulgation of a false perspective of their toxicity has compromised our ability to advise our patients and participate in the management of their disorders. The literature sources, from which the false perspective derives, do not accurately reflect safety and fail to address the value of appropriate drug use monitoring. We, as rheumatologists, must stand up and proactively address engrained misconceptions-if we are to be able to continue to provide safe, effective care for our patients.
Core tip: Non-steroidal anti-inflammatory drugs are safe when appropriately dosed and renal function monitored. Evaluation for complete blood count, comprehensive metabolic panel and urinalysis within two weeks of initiation, at dose augmentation and with use of interacting or hemodynamically-altering concomitant medications, and again at a month and at three month intervals provides an appropriate monitoring regimen.