Using nonsteroidal anti-inflammatory drugs

Ischaemic heart disease - Using nonsteroidal anti-inflammatory drugs Factor

There are many anti-inflammatory drugs that do not contain steroids.  Most commonly they are treatment for arthritic conditions but may also be used for muscle strains associated with sporting injuries.  Although aspirin is a non-steroidal anti-inflammatory drug (NSAID), it is excluded from this SOP factor.  Examples of NSAIDs (other than aspirin) include:

• Phenylbutazone (Butazolidine - BTZ)
• Indomethacin (Indocid, Hicin, Indomed)
• Naproxen (Naprosyn, Naprogesic)
• Ibuprofen (Brufen, Nurofen, Rafen)
• Piroxicam (Feldene, Fensaid, Mobilis)
• Ketoprofen (Orudis, Oruvail)
• Sulindac (Clusinol, Clinoril)
• Tenoxicam (Tilcotil)
• Diclofenac sodium (Voltaren, Fenac)
• Celecoxib (Celebrex)
• Rofecoxib (Vioxx).

These are usually prescribed medications, but some, such as Nurofen and Naprogesic, are available without a doctor's prescription.

Last reviewed for CCPS 27 April 2010.

Investigative Documents

Preliminary questions [38927]

39031 there is some evidence that a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, may be a factor in the development or worsening of the condition under consideration.

39032 the veteran has used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days at some time.

39033 the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days for treatment of an illness or injury which is identifiable.

39034  the veteran has established the causal connection between using a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, and VEA service for ischaemic heart disease.

39035   the veteran has established the causal connection between using a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, and VEA service for the clinical onset of ischaemic heart disease.

39038  the veteran has established the causal connection between using a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs and eligible service for the clinical onset of ischaemic heart disease.

or

39037  the veteran has established the causal connection between using a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, and operational service for the clinical onset of ischaemic heart disease.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

39036   the veteran has established the causal connection between using a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, and VEA service for the clinical worsening of ischaemic heart disease.

39040  the veteran has established the causal connection between using a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs and eligible service for the clinical worsening of ischaemic heart disease.

or

39039  the veteran has established the causal connection between using a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, and operational service for the clinical worsening of ischaemic heart disease.

Clinical onset and operational service [39037]

39041 for treatment of the identified illness or injury, the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days before the clinical onset of ischaemic heart disease.

39043 where, for treatment of the identified illness or injury the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days, the last dose of the drug was taken within the seven days before the clinical onset of ischaemic heart disease.

39045  the identified illness or injury, for treatment of which the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days, is causally related to operational service.

Clinical onset and eligible service [39038]

39047 for treatment of the identified illness or injury, the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days.

39048 for treatment of the identified illness or injury, the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days before the clinical onset of ischaemic heart disease.

39050 where, for treatment of the identified illness or injury the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days, the last dose of the drug was taken within the seven days before the clinical onset of ischaemic heart disease.

39052  the identified illness or injury, for treatment of which the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days, is causally related to eligible service.

Clinical worsening and operational service [39039]

39042 for treatment of the identified illness or injury, the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days before the clinical worsening of ischaemic heart disease.

39044 where, for treatment of the identified illness or injury the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days, the last dose of the drug was taken within the seven days before the clinical worsening of ischaemic heart disease.

39045  the identified illness or injury, for treatment of which the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days, is causally related to operational service.

39046 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, for treatment of which the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days, is causally related.

Clinical worsening and eligible service [39040]

39047 for treatment of the identified illness or injury, the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days.

39049 for treatment of the identified illness or injury, the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days before the clinical worsening of ischaemic heart disease.

39051 where, for treatment of the identified illness or injury the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days, the last dose of the drug was taken within the seven days before the clinical worsening of ischaemic heart disease.

39052  the identified illness or injury, for treatment of which the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days, is causally related to eligible service.

39053 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, for treatment of which the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days, is causally related.