non-steroidal anti-inflammatory drugs in palliative care

Last reviewed 01/2018

Indications as analgesics in palliative care, including action as adjuvant analgesic:

  • bone pain
  • soft tissue pain due to malignant infiltration
  • arthritis
  • possible role in early management of neuropathic pain

Assess analgesic response after regular use for one week.

Patients considered to be at risk of NSAID induced gastroduodenal ulceration (age over 65 years, past history of PUD, concomitant oral steroids or anticoagulants, serious comorbidity) should receive a gastroprotective drug such as a proton pump inhibitor.

Extreme caution in renal failure. Fluid retention and renal function may all be worsened by NSAIDs.

NSAIDs may be considered for asthmatic patients unless they have a history of aspirin sensitivity.


  1. West Midlands Palliative Care Physicians (2007). Palliative care - guidelines for the use of drugs in symptom control.