We identified and analysed 454 (5%) people with oral cancer (279 men, 175 women, mean [SD] age at diagnosis  years) and 454 matched controls (n=908); 263 (29%) had used NSAIDs, 83 (9%) had used paracetamol (for a minimum of 6 months), and 562 (62%) had used neither drug. NSAID use (but not paracetamol use) was associated with a reduced risk of oral cancer (including in active smokers; hazard ratio , 95% CI -, p<). Smoking cessation also lowered the risk of oral cancer (, -, p<). Additionally, long-term use of NSAIDs (but not paracetamol) was associated with an increased risk of cardiovascular-disease-related death (, -, p=). NSAID use did not significantly reduce overall mortality (p=).
Formulations of topical diclofenac, ibuprofen, ketoprofen, piroxicam, and indomethacin demonstrated significantly higher rates of clinical success (more participants with at least 50% pain relief) than matching topical placebo (moderate or high quality data ). Benzydamine did not. Three drug and formulation combinations had NNTs for clinical success below 4. For diclofenac, the Emulgel® formulation had the lowest NNT of (95% CI to ) in two studies using at least 50% pain intensity reduction as the outcome . Diclofenac plasters other than Flector® also had a low NNT of ( to ) based on good or excellent responses in some studies. Ketoprofen gel had an NNT of ( to ), from five studies in the 1980s, some with less well defined outcomes. Ibuprofen gel had an NNT of ( to ) from two studies with outcomes of marked improvement or complete remission. All other drug and formulation combinations had NNT values above 4, indicating lesser efficacy .
Shake well before use then remove cap. Metacam Oral Suspension may be either mixed with food or placed directly into the mouth. Particular care should be given with regard to the accuracy of dosing. Metacam Oral Suspension can be given using the measuring syringe provided in the package (see dosing procedure below). The syringe fits on to the bottle and has a scale in pounds designed to deliver the daily maintenance dose ( mg/lb or mg/kg). When using the syringe, the dog’s weight should be rounded down to the nearest 5 pound increment. Alternatively, Metacam Oral Suspension can be given using the dropper bottle: one drop for each pound of body weight for the mg/mL concentration (two drops for each kilogram of body weight). Replace and tighten cap after use.