The selection of a nonsteroidal antiinflammatory drug. Is there a difference?

The availability of an ever expanding number of nonsteroidal antiinflammatory drugs (NSAID) relates to their utility for the treatment of a broad spectrum of disorders. Both the efficacy and adverse effects of NSAID relate primarily to their antiprostaglandin mechanism of action, prostaglandin inhibition. At full antiinflammatory doses, there is little evidence to support a rank order of effectiveness. The major differences among NSAID are their half-lives and safety profiles. With newer agents the emphasis is on safety, especially with respect to gastrointestinal irritation. Acknowledgment of inherent drug differences with respect to pharmacology and safety enhances tolerability by the patient and increases the likelihood for continued drug therapy.