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ASAS Defined NSAID Intake
NSAIDs
NSAID
Average
Daily Intake
Days with
Intake
Start Date
End Date
Add NSAID Medication
Medication name:
Aceclofenac
Celecoxib (Celebrex)
Diclofenac (Voltaren)
Etodolac (Ultradol)
Etoricoxib
Flurbiprofen (Froben)
Ibuprofen (Advil)
Indomethacin (Indocid)
Ketoprofen (Orudis, Orovail)
Meloxicam (Mobicox)
Naproxen (Naprosyn, Aleve)
Nimesulide
Phenylbutazone
Piroxicam (Feldene)
Tenoxicam (Mobiflex)
Other, please specify:
Average Daily Intake:
mg
Days With Intake:
<1 day/week
1-3 days/week
3-5 days/week
>5 days/week
Every day
Start Date (if known):
DD-MMM-YYYY
End Date (if applicable):
DD-MMM-YYYY
