NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of drugs commonly used for the reduction of mild to moderate pain, inflammation, fever, and stiffness -- as well as for medical conditions related to pain and inflammation. They work by inhibiting the action of certain hormones that cause inflammation and pain in the body. A few common side effects include nausea, an unexplained rash, and stomach pain.

What Are NSAIDs?

Nonsteroidal anti-inflammatory drugs, or NSAIDs, are a class of medicines used to reduce:
 
  • Mild to moderate pain
  • Inflammation
  • Fever
  • Stiffness.
 
They are also used to treat a number of medical conditions that cause pain and inflammation. Not all NSAIDs are approved for the same uses.
 
NSAIDs are available in both prescription and non-prescription strengths. They are also available in both brand-name and generic versions. NSAIDs may also be used alone or combined with other medications in several common cold, flu, and sinus products. These medications can help relieve aches, pains, and fever that result from common cold symptoms, flu symptoms, or sinus problems.
 
(Click What Are NSAIDs Used For? for more information, including possible off-label uses.)
 

How Do They Work?

NSAIDs are thought to work by inhibiting the action of certain hormones that cause inflammation and pain in the body. These hormones are called prostaglandins.
 

Effects of NSAIDs

By blocking the effects of prostaglandins, NSAIDs are useful at reducing pain and inflammation related to bone, muscle, or tendon injury. These medications can also help reduce fever and alleviate pain or joint swelling associated with different forms of arthritis and other conditions.
 

When and How Do I Take Them?

Some general considerations for when and how to take NSAIDs include the following:
 
  • For NSAIDs to work properly, you have to take them as prescribed. They will not work if you stop taking them.
     
  • It is important to take the lowest effective dose for the least amount of time in order to treat your condition. This will decrease the chances of serious side effects occurring.
     
  • If using over-the-counter NSAID products (such as Motrin® or Aleve®), you should follow the instructions on the label. Do not exceed the recommended dosage and do not take them for more than ten days for pain relief, or three days for fever, unless your healthcare provider recommends otherwise.
     

Dosing Information

The dosage of NSAIDs your healthcare provider recommends will vary, depending on a number of factors, including:
 
  • The specific type of NSAID
  • The medical condition you are being treated for
  • Other medical conditions you may have
  • Other medications you may be taking.
     
As always, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
 

Side Effects of NSAIDs

As with any medicine, side effects are possible with NSAIDs. Yet, not everyone who takes them will experience side effects. In fact, most people tolerate the medications well. If people do develop side effects, in many cases, they are minor, meaning they require no treatment or are easily treated by you or your healthcare provider.
 
The most common side effects include:
 
  • Nausea
  • Abdominal pain (stomach pain)
  • Heartburn
  • Dizziness
  • An unexplained rash.
     
Less common but potentially serious side effects include:
 
 
Any medication that is part of the NSAIDs class of drugs can cause these serious side effects, which can lead to life-threatening complications or even loss of life.
 
(Click NSAIDs Side Effects to learn more, including other serious side effects to report to your healthcare provider.)
 

What Should I Tell My Healthcare Provider?

The U.S. Food and Drug Administration (FDA) warns that people using NSAIDs may have a higher risk of having a heart attack or stroke than those people who do not take them. This warning does not apply to those who take aspirin. This risk may be higher in people who have been taking NSAIDs for a long time. These events can occur without any warning and can lead to death. Be sure to tell your healthcare provider if you have or have ever had any of the following:
 
Prior to taking NSAIDs, you should also tell your healthcare provider if you have:
 
  • Asthma
  • Congestive heart failure
  • Liver disease or failure
  • Kidney disease or failure
  • Bleeding problems (or if you are taking medicine that decreases your blood's ability to clot)
  • Diabetes
  • Nasal polyps
  • Systemic lupus erythematosus (lupus or SLE)
  • Stomach ulcers, stomach bleeding, or a history of either condition
  • Any allergies to medicines, including sulfa drugs, aspirin, or other NSAID pain medicines.
     
Also, let your healthcare provider know if you:
 
  • Are pregnant or thinking about becoming pregnant (see NSAIDs and Pregnancy)
  • Are breastfeeding
  • Drink alcohol frequently
  • Smoke
  • Are having or have recently had heart surgery.
     
You should also tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 
(Click NSAIDs Warnings and Precautions to learn more, including information on who should not take them.)
 

Who Should Not Take NSAIDs?

You should not take NSAIDs if you:
 
  • Are allergic to any brand of NSAIDs.
     
  • Have an active bleeding condition, such as a stomach ulcer or bleeding within the head.
     
  • Have an allergic reaction, hives, or asthma that is caused by aspirin or other NSAIDs.
     
  • Are having or have recently had coronary artery bypass graft surgery (often known as open heart surgery, bypass surgery, or CABG).
     
  • Are in the third trimester of pregnancy or nursing.
     

What If I Take an Overdose?

People who take too much NSAIDs may have overdose symptoms that could include but are not limited to:
 
  • Vomiting
  • Difficulty breathing
  • Dizziness
  • Excessive sleepiness
  • Coma.
     
If you happen to take an overdose, seek immediate medical attention.
 

Examples of NSAIDS

There are many different NSAIDs. The following is a list of the more common ones:
 
Rofecoxib (Bextra®) and valdecoxib (Vioxx®) are also NSAIDs. However, they have been withdrawn from the market due to safety concerns and are no longer available.

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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;
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