Non-steroidal anti-inflammatory drugs (NSAIDs) are a medication widely used to:
- relieve pain
- reduce inflammation (redness and swelling)
- bring down a high temperature (fever)
NSAIDs are used to treat a wide range of conditions.
Common acute (short-term) conditions that can be treated with NSAIDs include:
- headaches
- painful periods
- toothache
- soft tissue injuries such as sprains and strains
- infections, such as the common cold or the flu (NSAIDs do not treat the underlying infections, but can help to relieve symptoms; especially fever)
Common chronic (long-term) conditions that can be treated with NSAIDs include:
- most types of arthritis, including rheumatoid arthritis and osteoarthritis
- back pain
- neck pain
Things to consider when using NSAIDs
NSAIDs are associated with a small increase in the risk of a person experiencing a heart attack, stroke or heart failure.
NSAIDs are only used in people who have an existing high risk of developing these types of conditions if there are no suitable alternatives and the medications bring significant benefit.
High-risk groups include:
- those with a history of previous heart attack, stroke or heart failure
- people aged 75 or over
- people with diabetes
- smokers
- people with high blood pressure
NSAIDs are also not usually recommended for people who:
- are pregnant or breastfeeding
- have a history of kidney disease
- have a history of liver disease
- have active stomach ulcers (a sore in the lining of the stomach), or are at risk of developing stomach ulcers
Read more about the things to consider when using NSAIDs.
For people who are unable to take NSAIDs for medical reasons, the painkiller paracetamol can be used as a safe alternative. For more severe pain, prescription painkillers, such as codeine or tramadol, can be tried.
Or in cases of severe inflammation an injection of steroids (corticosteroids) can often help.
Read more about alternatives to non-steroidal anti-inflammatory drugs.
Side effects
Most people take NSAIDs without having any side effects. Short term use is unlikely to cause significant problems, especially in younger patients.
If side effects do occur they usually affect the stomach and intestines (gastrointestinal tract) and can include:
- indigestion
- stomach ulcer
- allergic reactions
In older patients (aged over 55), or those who have had previous stomach ulcers, but who need long term NSAID treatment, stomach acid suppression medications are often prescribed in combination with NSAIDs to reduce the risk of stomach ulcer complications.
Read more about the side effects of NSAIDs.
Interactions
It is very important to read the patient information leaflet that comes with your medication as some NSAIDs can either react unpredictably with other medications, or make them less effective.
For example, it is usually not recommended to take an NSAID if you are also taking medication to prevent blood clots such as low-dose aspirin or warfarin.
Read more about potential interactions that can occur with NSAIDs.
Dosage
NSAIDs are available in:
- tablet or capsule form
- as a topical treatment (a cream, gel or lotion rubbed into a specific part of the body)
- eye drops – used to treat eye pain
Less commonly, NSAIDs are used as a suppository – a capsule inserted into the rectum (back passage).
It is important to strictly follow all of the instructions about the recommended dosage for your particular NSAID. If you exceed the recommended dose, you risk experiencing a wide range of adverse effects, some of which can be serious.
Read more about the recommendations on dosage for NSAIDs.
Names
In Europe, the most commonly prescribed NSAIDs are:
- diclofenac
- ibuprofen
- naproxen
- celecoxib
- mefenamic acid
- etoricoxib
- indometacin
- aspirin (in doses greater than 600mg)
Most of the NSAIDs listed above are generic medicines. This means that their production and distribution is not limited to a single company. Therefore, they are available under a range of different brand names.
Some NSAIDs are available over-the-counter, without the need for a prescription, such as aspirin, diclofenac, naproxen and ibuprofen.
However, because a medication is available over the counter it does not mean it is safe or suitable for everyone. Again, it is important to read the patient information leaflet that comes with your medication.
It is generally accepted that naproxen is the safest NSAID with regard to heart attacks and strokes and celecoxib is the safest with regard to stomach problems.
Note: Aspirin must NOT be given to children unless directed by a doctor. Also, some people with asthma get attacks triggered by aspirin or NSAIDs.
- Anti-inflammatory
- Anti-inflammatory medicines reduce swelling and inflammation.
- Fever
- A fever is when you have a high body temperature (over 38C or 100.4F).
- Inflammation
- Inflammation is the body’s response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
- Joints
- Joints are the connection point between two bones that allow movement.
- Migraines
- A migraine is type of recurring headache. It is usually accompanied by nausea, vomiting and sensitivity to light and sound.