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My comments were specifically addressed to the treatment of primary dysmenorrhea and stated that the benefits of the NSAI drugs were too quickly dismissed if by chance the first prescribed drug did not work for that particular patient. Based on six years' experience with thousands of women, I suggested that a change to a different NSAI is most often all that is required.Obviously, not all NSAIs are equivalent to each other, although overall they often give clinically similar results. The fact that they can differ clinically is borne out by the finding that patients with primary dysmenorrhea may respond to one drug and not another and that failure on one treatment may often be corrected by changing to another drug of the same type. These same therapy problems are known to occur in other disorders, ie, inflammatory joint disease, but they are poorly understood."Chemical idiosyncrasy" concerns
Budoff PW. Treatment of Dysmenorrhea-Reply. JAMA. 1982;247(16):2234. doi:10.1001/jama.1982.03320410019017