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Cervical Spondylosis Medication

Updated: May 05, 2017
Author: Hassan Ahmad Hassan Al-Shatoury, MD, PhD, MHPE; Chief Editor: Dean H Hommer, MD
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MEDICATION

Medication Summary
The goal of pharmacotherapy is to reduce morbidity and prevent complications.

Nonsteroidal anti-inflammatory drugs

Class Summary

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used in the treatment of cervical spondylosis. If
one class seems to be ineffective after a 2-week trial, a formulation from another class may be
tried. The most commonly used NSAIDs are ibuprofen, acetylsalicylic acid, naproxen,
indomethacin, meloxicam, and piroxicam.

Naproxen (Anaprox, Naprelan, Naprosyn, Aleve)

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Relieves mild to moderately severe pain and inhibits inflammatory reactions, probably by
decreasing the activity of the enzyme cyclooxygenase, thus inhibiting prostaglandin synthesis.

Ibuprofen (Ibuprin, Advil, Motrin)

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NSAID from propionic acid derivatives group. Effective inhibitor of cyclo-oxygenase, which is
responsible for biosynthesis of prostaglandins. Rapidly absorbed after oral administration. Half-life
in plasma is about 2 h. Ibuprofen passes slowly into the synovial spaces and may remain there in
higher concentration as the concentration in plasma declines. Excretion is rapid and complete
(mainly excreted in urine as metabolites or conjugates).

Indomethacin (Indocin, Indochron E-R)

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Rapidly absorbed; metabolism occurs in the liver by demethylation, deacetylation, and glucuronide
conjugation. Indomethacin inhibits prostaglandin synthesis.

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Piroxicam (Feldene)

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Decreases the activity of cyclooxygenase, which in turn inhibits prostaglandin synthesis;

piroxicam's effects decrease the formation of inflammatory mediators.

Aspirin (Anacin, Ascriptin, Bayer Aspirin)

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Treats mild to moderately severe pain and headache. The drug inhibits prostaglandin synthesis,
which prevents the formation of platelet-aggregating thromboxane A2; aspirin acts on the heat-
regulating center of the hypothalamus and vasodilates peripheral vessels to reduce fever. By
inhibiting prostaglandin synthesis, aspirin may also inhibit key steps in the inflammation process.

Meloxicam (Mobic, Vivlodex)

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Meloxicam has anti-inflammatory effects systemically and can reduce the effect of local
inflammatory mediators.

Corticosteroids
Class Summary

Corticosteroids have potent anti-inflammatory properties. These medications can be given as a

brief tapered course of oral treatment.

Prednisone (Deltasone, Orasone, Sterapred)

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Glucocorticoid steroid used to treat a variety of inflammatory conditions. Prednisone may decrease
inflammation by reversing increased capillary permeability and suppressing PMN activity. Dosages
may be adjusted for individual sensitivities and associated medical conditions.

Muscle relaxants
Class Summary

Muscle relaxants are used to treat muscle spasm, which may play a role in patient discomfort.

Methocarbamol (Robaxin)

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Skeletal muscle relaxant used in conjunction with other therapies to treat pain and discomfort
associated with musculoskeletal conditions. Reduces nerve impulse transmission from spinal cord
to skeletal muscle.

Antidepressants
Class Summary

These agents are useful in select cases of chronic pain.

Amitriptyline (Elavil)

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Antidepressant with sedative effects. The mechanism of action is unknown. Amitriptyline is not an
MAOI and does not act primarily by stimulating CNS.

Follow-up

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