The Basics: NSAIDs
What Are NSAIDs?
Non-steroidal anti-inflammatory drugs, or NSAIDs, are medicines that relieve pain and reduce inflammation.
They're used to treat a variety of conditions, including:
The drugs work by blocking the production of , chemicals in the body that cause pain and inflammation.
Aspirin was the first NSAID, made in 1897 when German chemist Felix Hoffman and the Bayer Company converted salicylic acid into acetylsalicylic acid.
However, the key ingredient in aspirin — white willow bark — has been used since ancient times.
NSAIDs are available in both prescription and over-the-counter (OTC) forms.
Prescription NSAIDs include:
- Celecoxib (Celebrex)
- Diclofenac (Voltaren)
- Diflunisal (Dolobid)
- Etodolac (Lodine)
- Fenoprofen (Nalfon)
- Flurbiprofen (Ansaid)
- Ibuprofen (Motrin)
- Indomethacin (Indocin)
- Ketoprofen (Orudis)
- Ketorolac tromethamine (Toradol)
- Meclofenamate sodium (Meclomen, Ponstel)
- Mefenamic acid meloxicam (Mobic)
- Nabumetone (Relafen)
- Naproxen sodium (Anaprox)
- Oxaprozin (Daypro)
- Phenylbutazone (Butazolidin)
- Piroxicam (Feldene)
- Sulindac (Clinoril)
- Tolmetin (Tolectin)
- Salicylate (Trilisate Disalcid)
NSAIDs available without a prescription include:
- Ibuprofen (Motrin, Advil, Nuprin, Medipren)
- Aspirin (Bayer, Excedrin, Bufferin)
- Naproxen sodium (Aleve)
- Ketoprofen (Orudis KT)
NSAIDs can cause severe or life-threatening gastrointestinal (GI) bleeding and ulcers in some people.
NSAIDs have also been linked to a higher risk of strokes, heart attacks, and heart-related deaths, especially when used for a long period of time.
Additionally, the drugs can worsen high blood pressure, and may cause kidney damage in people over 60 years of age.
Tell your doctor if you have the following conditions before taking an NSAID:
Researchers have found that a type of NSAID known as COX-2 inhibitors (such as Celebrex) are less likely to cause GI bleeding and pain.
Tell your physician about all other medicines, recreational drugs, and supplements you're taking while on NSAIDs.
Because different medications — such as combination drugs used to treat the symptoms of colds or flu — may contain different types of NSAIDs, be aware when taking these drugs to avoid the risks of serious side effects or overdose.
NSAID Side Effects
Some common side effects of NSAIDs include:
- Stomach pain
- Vomiting, diarrhea, or constipation
- Mild headache
NSAIDs can cause serious side effects. Tell your doctor right away if you experience any of the following:
- Swelling of the mouth, face, lips, tongue, ankles, feet, lower legs, hands, or eye area
- Ringing in the ears (tinnitus)
- Severe rash or hives
- Red, peeling skin
- Unexplained bruising and bleeding
- Unusual weight gain
- Stools that are bloody, black, or tarry
- Bloody or cloudy urine
- Blurred vision
- Severe stomach pain
- Vomit that looks like coffee grounds
- Wheezing, trouble breathing, or unusual cough
- Chest pain or fast heartbeat
- Flu-like symptoms
- Extreme fatigue
- Yellowing of the eyes or skin (jaundice)
- Sensitivity to light
NSAIDs and Pregnancy
The use of NSAIDs during pregnancy is somewhat controversial.
NSAID use during the third trimester of pregnancy is generally not recommended because of an increased risk of complications in a newborn baby.
There is also some evidence that suggests using prescription-strength NSAIDs during the first half of pregnancy may increase the risk of miscarriage.
In 2015, the Food and Drug Administration (FDA) issued the following statement regarding the use of NSAIDs and other pain medications during pregnancy:
"Pregnant women should always consult with their healthcare professional before taking any prescription or OTC medicine. Women taking pain medicines who are considering becoming pregnant should also consult with their healthcare professionals to discuss the risks and benefits of pain medicine use."
NSAIDs are generally considered safe to use during breastfeeding.
NSAIDs for Dogs
Some NSAIDs are approved for managing pain in dogs.
They're often used in animals with arthritis or those that have just had surgery.
NSAIDs for dogs include:
- Carprofen (Novox or Rimadyl)
- Deracoxib (Deramaxx)
- Etodolac (Etogesic)
- Firocoxib (Previcox)
- Meloxicam (Metacam)
- Tepoxalin (Zubrin)
These medicines are usually safe for dogs, but they have risks and may cause liver, kidney, or digestive problems.
Talk to your veterinarian before giving your dog an NSAID.
Video: NSAIDs and Heart Disease - Mayo Clinic
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