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Home Formulary 10.0 Musculoskeletal and Joint Diseases 10.3 Topical NSAIDs

10.3 Topical NSAIDs

ChoiceDrug
1st choiceIbuprofen 5% gel
2nd choice Piroxicam 0.5% gel

Prescribing notes

  • In osteoarthritis (OA), topical NSAIDs are a first-choice treatment and should be offered to people with knee OA and considered for OA of other joints. Topical NSAIDs should be considered before oral NSAIDs.
  • All topical NSAIDS are considered equally efficacious therefore ibuprofen 5% gel should be prescribed as the 1st line NSAID gel of choice.
  • Prescribing of rubefacients is not supported by DoH, see HSC Limited Evidence List and Stop List.
  • Patients should be advised against excessive exposure to sunlight to the area treated in order to avoid possibility of photosensitivity. Those who use topical ketoprofen should avoid direct sunlight and sunbeds, see MHRA.

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