Compounding For Him - Osteoarthritis

Osteoarthritis (OA) is a disease of the joints that causes people to suffer chronic pain and limits range of motion. OA is the most common chronic condition of the joints, affecting approximately 33 million Ameri-cans. OA is common in all races and back-grounds. It usually appears after age 45. Men under age 55 are more likely to have OA than women in the same age range.[1]

Osteoarthritis - What causes it?

Despite the prevalence of the disease, the causes of osteoarthritis are not completely understood. There is no cure. Many differ-ent factors may play a role in whether or not you get OA: [1]

  • Age
  • Obesity
  • Injury or Overuse
  • Genetics
  • Muscle Weakness

Osteoarthritis - How is it treated?

At some point in their treatment, most peo-ple will try nonsteroidal anti-inflammatory drugs (NSAIDs) to help relieve the discom-fort associated with OA. Some common generic NSAIDs that you may be familiar with include ibuprofen, naproxen, ketopro-fen, and diclofenac. These medications do a good job of reducing and relieving pain, inflammation, and swelling; as the following studies indicate

  1. “Analgesic efficacy and safety of nonpre-scription doses of naproxen sodium com-pared with acetaminophen in the treat-ment of osteoarthritis of the knee" (Am J Ther. 2004 Mar-Apr;11(2):85-94).
  2. “Efficacy and safety of 5% ibuprofen cream treatment in knee osteoarthritis. Results of a randomized, double-blind, placebo-controlled study" (J Rheumatol. 2004 Mar;31(3):565-72).
  3. “An alternative topical treatment of os-teoarthritis of the knee with cutaneous diclofenac solution" (Expert Opin Phar-macother. 2008 Jul;9(10):1805-16).

However, they can cause stomach distress and ulcers when taken orally as stated by the American Academy of Gastroenterology - "Another common cause of peptic ulcer disease is the regular use of pain medications called non-steroidal anti-inflammatory drugs (NSAIDs), which include aspirin, ibuprofen, naproxen, ketoprofen, meloxicam and celecoxib. People typically take NSAIDs to reduce pain and inflamma-tion, often for arthritis. Frequent or longtime use of NSAIDs, especially among older per-sons, however, can increase a person’s risk of developing an ulcer."

Osteoarthritis - How we can help you!

Recently, several current guidelines for management of osteoarthritis (OA) recommend topical NSAIDs, indicating them as a safe and effective treatment. One guideline recommends that topical NSAIDs be considered as first-line pharma-cologic therapy. A US guideline for knee OA recommends topical NSAIDs in older pa-tients and in patients with increased gastroin-testinal risk.[2]

Patient Benefits

There are numerous benefits that you can experience by utilizing topical NSAIDs:

  • Fewer systemic side effects including stomach ulcers and gastritis
  • Ease of use and administration
  • Pharmacologically effective and cost effective - typically less than $2/day
  • Dosing flexible and can be combined with other medications

Formulating medication therapies for indi-vidual patient need is what we specialize in. For more information on how we may be able to help you find relief from your os-teoarthritis pain, please call us and ask to speak with one of our compounding phar-macists. You’ll be glad you did!


  • Arthritis Foundation -
  • New guidelines for topical NSAIDs in the osteoarthritis treatment paradigm - Altman, RD - (Curr Med Res Opin. 2010 Dec;26(12):2871-6)