Osteoarthritis (OA) is a musculoskeletal progressive disease, with an affected knee joint. The pharmacological treatment of knee osteoarthritis is considered symptomatic therapy, which often secures the retainment of mobility of the patient. The pharmacological interventions of OA are suggested by recent guidelines, such as AAOS (American Academy of Orthopedic Surgeons), and ACR/AF (American College of Rheumatology/Arthritis Foundation).
| Drug | Dosage |
| Acetaminophen (Paracetamol) | Maximum 4g/day |
| Non-steroidal anti-inflammatory drugs (NSAIDs) | |
| Ibuprofen | low dose (400 mg thrice daily) or medium dose (600 mg thrice daily), max 3200 mg daily |
| Naproxen | low dose (250 mg thrice daily) or medium dose (500 mg twice daily), with a maximum of 1250 mg daily. |
| Diclofenac | 50 mg twice daily or 75 mg twice daily, with a maximum of 200 mg daily |
| Celecoxib | 200 mg once daily of low dose to maximum dose of 200 mg twice daily |
| Gastroprotective agents | |
| Misoprostol | Standard dose 200 μg once daily |
| Proton pump inhibitor | |
| Omeprazole | 40 mg once daily |
| Opioid analgesics | |
| Codeine | 10 mg twice daily |
| Fentanyl patch | 25 μg |
| Tramadol | 50 to 100 mg every 4 to 6 hours |
| Oxycodone | 20 mg daily |
| Topical NSAIDs | |
| Topical Capsaicin | |
| Glucosamine and Chondroitin sulfate | |
| Intraarticular glucocorticoids | |
| Methylprednisolone acetateTriamcinolone acetonide | 20 to 40 mg; once in every 3 months |
| Intraarticular Hyaluronic acid | |
| Duloxetine | |
| Bisphosphonates | |
| Hydroxychloroquine | |
| Methotrexate | |
| Intraarticular Botullinum toxin.[1] |
Suggested approach to the treatment of OA as per the American Academy of Physicians:
First-line pharmacotherapy: Full-dose of Acetaminophen, topical therapies.
Second-line treatments: Oral NSAIDs
Third-line treatments: Tramadol or Duloxetine
Fourth-line treatments: Opiates (50 mg of Hydrocodone or ≤ 30 mg of Oxycodone per day)
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