Nonsteroidal anti-inflammatory drugs (NSAIDs)

Examples

Nonsteroidal anti-inflammatory drugs (NSAIDs) you can buy without a prescription (not a complete list)

Generic Name Brand Name
ibuprofen Advil, Motrin
naproxen Aleve
aspirin Bayer, Bufferin

Because aspirin can increase the risk of bleeding, it is not recommended for new injuries. Take other medicines such as ibuprofen or naproxen for the first 2 or 3 days after an injury.

Prescription NSAIDs (not a complete list)

Generic Name Brand Name
celecoxib Celebrex
ibuprofen Motrin
ketoprofen  
naproxen Anaprox
piroxicam Feldene
sulindac Clinoril

If your doctor prescribed NSAIDs, take them exactly as prescribed. Call your doctor if you have any problems with your medicine. Always read and follow all instructions on the label.

How It Works

NSAIDs reduce inflammation and relieve fever and pain by blocking enzymes and proteins made by the body. NSAIDs such as ibuprofen and naproxen block a protein (called prostaglandin) that makes heavy menstrual bleeding worse. Aspirin does not block this protein.

Why It Is Used

NSAIDs relieve pain and fever. They also reduce swelling and inflammation caused by an injury or a disease such as arthritis.

Some NSAIDs, such as ibuprofen and naproxen, help ease cramping and reduce blood loss from heavy menstrual bleeding.

Low-dose aspirin is often recommended to help prevent heart attack or stroke. Consult your doctor before using aspirin on a regular basis.

Aspirin should not be used for gout. It can make gout worse by raising the uric acid level in the blood.

How Well It Works

NSAIDs work well to relieve pain, decrease fever, and reduce swelling and inflammation caused by an injury or disease.1 Some NSAIDs help reduce heavy menstrual bleeding2.3 NSAIDs can help relieve the pain of kidney stones.4

Side Effects

The most common side effects of NSAIDs are stomach upset, heartburn, ulcers, and skin rashes. Taking NSAIDs with food may help prevent some of these problems. Your chances of having these side effects are greater if you take large doses of NSAIDs or take them for a long time.

Less common side effects include confusion; swelling of the face, feet, or lower legs; or a sudden decrease in the amount of urine. These side effects are more likely to occur in older adults and people with other serious health problems.

Aspirin, unlike other NSAIDs, has been shown to reduce the risk of heart attack and stroke. If you use other NSAIDs regularly, aspirin may not work as well to prevent a heart attack and stroke. Do not give aspirin to anyone younger than 20 unless your doctor tells you to. It has been linked to Reye syndrome, a rare but serious illness.

If you are pregnant, trying to become pregnant, or breast-feeding, talk to your doctor before you use NSAIDs. Do not use NSAIDs during pregnancy unless your doctor tells you to. They can cause problems with your baby or with delivery.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Do not take NSAIDs if you have had an allergic reaction to this type of medicine in the past. If you have been told to avoid a medicine, talk to your doctor before you take it.

Talk to your doctor before taking NSAIDs if you have:

  • Ulcers or a history of bleeding in your stomach or intestines.
  • Stomach pain, upset stomach, or heartburn that lasts or comes back.
  • Anemia .
  • Bleeding or easy bruising.
  • A habit of drinking more than 3 alcohol drinks a day. This increases your risk of stomach bleeding.
  • High blood pressure.
  • Kidney, liver, or heart disease.

Be sure to tell your doctor about all the nonprescription and prescription medicines you take. Talk to your doctor before using NSAIDs if you take:

  • Blood thinners, such as warfarin (for example, Coumadin), heparin, or aspirin.
  • Medicine to treat mental health problems.
  • Medicine to decrease swelling (water pills).
  • Medicine for arthritis or diabetes.

If you take NSAIDs regularly, your doctor may recommend that you also take a medicine such as a proton pump inhibitor (PPI). These medicines can help protect the stomach lining.5

Do not use a nonprescription NSAID for longer than 10 days without talking to your doctor.

NSAIDs are strong medicines. The actions they take in your body to help one condition can cause problems in other ways. For example, NSAIDs block chemicals called prostaglandins, which cause inflammation. So blocking prostaglandins decreases inflammation in the body. But prostaglandins also protect the lining of the stomach, so blocking prostaglandins can cause stomach irritation.

Talk to your doctor before you give fever medicine (such as an NSAID) to a baby who is 3 months of age or younger. This is to make sure a young baby's fever is not a sign of a serious illness.

To decide whether NSAIDs are right for you and to choose an NSAID to try, you and your doctor will consider:

  • The possible benefits of NSAIDs for your condition.
  • Any other medical conditions or risks that you have, including problems with your stomach or intestines (gastrointestinal problems), or with your heart or blood vessels (cardiovascular problems).
  • Other medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Gøtzsche PC (2007). Non-steroidal anti-inflammatory drugs, search date December 2006. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.
  2. Bohn Y (2002). Dysmenorrhea. In DR Mishell et al., eds., Management of Common Problems in Obstetrics and Gynecology, 4th ed., pp. 236–238. Malden, MA: Blackwell.
  3. Duckitt K, Collins S (2008). Menorrhagia, search date September 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
  4. Teichman JMH (2004). Acute renal colic from ureteral calculus. New England Journal of Medicine, 350(7): 684–693.
  5. Chan FKL, et al. (2007). Combination of a cyclo-oxygenase-2 inhibitor and a proton-pump inhibitor for prevention of recurrent ulcer bleeding in patients at very high risk: A double-blind randomised trial. Lancet, 369(9573): 1621–1626.

Last Updated: February 3, 2010

Author: Shannon Erstad, MBA/MPH

Medical Review: William M. Green, MD - Emergency Medicine & Robert B. Keller, MD - Orthopedics

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