Nonsteroidal Anti-Inflammatory Drugs
NSAIDs are usually taken in pill or liquid form, but there are injectable options as well.
Conditions that may be treated with NSAIDs range from everyday headaches and muscle aches to rheumatoid arthritis and post-surgical pain.
Other conditions that may be treated with NSAIDs include back pain, dental pain, bursitis, and menstrual cramps, as well as the minor aches and fever associated with a common cold.
Many NSAIDs are available over the counter, without a prescription.
These medications include ibuprofen (Advil, Motrin), naproxen sodium (Aleve), and aspirin (Ascriptin, Bayer, Ecotrin).
According to the Food and Drug Administration, patients should not take a nonprescription NSAID for more than 10 days without consulting a doctor.
Other NSAIDs can be obtained only with a prescription from a doctor.
These medications include naproxen sodium (Anaprox), diclofenac potassium (Cambia, Cataflam), celecoxib (Celebrex), sulindac (Clinoril), oxaprozin (Daypro), piroxicam (Feldene), indomethacin (Indocin, Tivorbex), meloxicam (Mobic, Vivlodex), fenoprofen (Nalfon), naproxen (Naprelan, Naprosyn), naproxen/esomeprazole (Vimovo), diclofenac (Voltaren, Zorvolex), as well as the generic products diflunisal, etodolac, ketorolac tromethamine, meclofenamate, nabumetone, and salsalate.
All prescription NSAIDs work the same way to reduce pain and inflammation, but side effects and effectiveness vary from one person to another.
Patients may discover that one NSAID provides more relief or has more manageable side effects than the other, so it can take some trial and error to find the right fit.
However, all prescription NSAIDs carry warning labels about the potential for an increased chance of a heart attack, stroke, or stomach bleeding while using the medications.
The most common side effects associated with nonprescription or prescription NSAID use include heartburn, stomach pain, stomach ulcers, headaches, ringing in the ears, and allergic reactions such as rashes, wheezing or swelling in the throat.
Other potentially more severe side effects include liver and kidney problems, high blood pressure, and leg swelling.
To minimize the risk of side effects, take the smallest dose of NSAIDs necessary for pain relief, and take it with food to help reduce the risk of stomach discomfort.
Also, avoid single-dose NSAIDs unless 24-hour pain relief is required; the single-dose medications stay in the body longer and may increase the risk of side effects.
Nonprescription NSAIDs should not be used for more than three days to treat fever or more than 10 days for pain without consulting a doctor, according to the Cleveland Clinic.
Extended use of NSAIDs, whether prescription or nonprescription, should be monitored by a doctor to watch for side effects.
Nonprescription NSAIDs are not meant to be used for long periods of time, so patients seeking extended pain relief for chronic conditions such as arthritis or back pain should work with a doctor to identify an appropriate prescription medication.
Some NSAIDs take effect within a few minutes or hours, while other types may take a week before the patient notices the full benefits.
Most nonprescription NSAIDs work quickly but are short-acting and may be needed as often as every 4 to 6 hours.
Some prescription NSAIDs for conditions such as arthritis are taken once or twice daily, but they may be slower to take effect.
A doctor can help patients choose the right NSAID depending on their reason for needing the medication, health history, and other health conditions being treated, such as diabetes or asthma.
Before starting a new prescription NSAID, tell your doctor about any allergies you have, to food, medication, or anything else;
other medications you are taking; whether you are planning to become pregnant, and whether you have conditions including liver or kidney disease, stomach ulcers, heart disease, high blood pressure, trouble with bleeding or clotting, asthma, and growths in the nose (nasal polyps) that could impact breathing.
Be sure to ask a doctor how often to take the NSAIDs, how to store NSAIDs, whether to use the medication on an empty stomach or with food, and whether it should be administered at a pre-determined time of day.
Also, discuss whether a prescription NSAID will impact driving, working, or other activities and what side effects to expect.
Side effects vary slightly among NSAIDs, so your experience with one medication may not predict your experience with another.
Ask your doctor how long you should take the NSAIDs and how you will know that the medication is working.
WHEN NOT TO TAKE NSAIDs
NSAIDs are not approved for anyone who has had serious side effects from pain-relieving or fever-reducing medicines.
Ask a doctor before taking a nonprescription or prescription NSAID if you have stomach problems, an increased risk of stomach bleeding, high blood pressure, heart disease, liver or kidney disease, or asthma, or if you are taking diuretic meds.
Also, patients should be evaluated by a healthcare provider before taking an NSAID if they have conditions including poorly controlled diabetes, allergies to medications such as aspirin or other NSAIDs, active congestive heart failure, peptic ulcer disease, gastroesophageal reflux disease, and Crohn’s disease or ulcerative colitis.
Other individuals who should consult a doctor before taking NSAIDs include individuals aged 65 years and older, women in the third trimester of pregnancy, and anyone about to have surgery (including dental surgery).
Also, children and teenagers with viral infections should not take aspirin or products that contain aspirin because of the risk of a condition known as Reye’s syndrome, a rare but potentially serious swelling in the liver and brain.
Marks, Lynn. “What are NSAIDs?” Everydayhealth.com. October 16, 2015. https://www.everydayhealth.com/nsaid/guide/ (accessed November 23, 2018).
“Medication Guide for Non-Steroidal Anti-Inflammatory Drugs.” fda.gov. https://www.fda.gov/downloads/drugs/drugsafety/ucm089162.pdf (accessed February 25, 2019).
“Non-steroidal anti-inflammatory medicines (NSAIDs).” Cleveland Clinic. April 27, 2016. https://my.clevelandclinic.org/health/drugs/11086-non-steroidal-anti-inflammatory-medicines-nsaids (accessed November 25, 2018).