Nonsteroidal anti-inflammatory drugs (NSAIDs) are medicines you can take for pain relief. They are often sold over-the-counter (OTC). This means you can buy them without a prescription from your doctor. Some common brand names are Advil, Motrin, or Aleve. But these medicines are available by prescription, as well. Show Path to improved healthHow do prescription NSAIDs work?NSAIDs stop a certain kind of enzyme in your body from working. These are called cyclooxygenase enzymes (also called COX enzymes). COX enzymes speed up your body’s production of hormone-like substances called prostaglandins. Prostaglandins irritate your nerve endings and cause you to feel pain. They are also part of the system that helps your body control its temperature. By reducing the level of prostaglandins in your body, NSAIDs help relieve pain from conditions like arthritis. They also help reduce inflammation (swelling), lower fevers, and prevent blood from clotting. There are 2 classes of prescription NSAIDs: traditional and COX-2 inhibitors. Traditional NSAIDs include:
COX-2 inhibitors include: If you need to take a prescription NSAID, your doctor will help you find one that is right for you. What’s the difference between traditional NSAIDs and COX-2 inhibitors?You have 2 types of COX enzymes in your body: COX-1 and COX-2. Researchers believe that one of the jobs of COX-1 enzymes is to help protect your stomach lining. The COX-2 enzyme doesn’t play a role in protecting your stomach. Traditional NSAIDs stop both COX-1 and COX- 2 enzymes from doing their jobs. When COX-1 enzymes are blocked, pain and inflammation is reduced. But the protective lining of your stomach is also reduced. This can cause problems such as upset stomach, ulcers, bloating, and bleeding in your stomach and intestines. COX-2 inhibitors only stop COX-2 enzymes from working. The COX-2 enzyme doesn’t help to protect your stomach. So COX-2 inhibitors may be less likely to irritate your stomach or intestines. Things to considerLike all medicines, prescription NSAIDs can cause side effects. However, the side effects usually are not severe and are not experienced very often. Common side effects of prescription NSAIDs may include:
Serious, but rare, side effects of prescription NSAIDs may include:
In addition to the side effects listed above, people taking a COX-2 inhibitor may be at risk for:
Call your doctor as soon as possible if your side effects become severe. Is it safe to take NSAIDs for a long period of time?People who take NSAIDs increase their risk of developing severe bleeding in their stomachs. They may also be at risk for heart attacks and strokes. These risks get worse if they take higher doses. It also gets worse if they take these medicines for a long period of time. If you need to take pain medicine for longer than a week, you should discuss this risk with your family doctor. You may want to explore other pain treatment options. What is a drug interaction?If you use 2 or more medicines at the same time, the way your body processes each one can change. When this happens, the risk of side effects from each one increases. Each medicine may not work the way it should. This is called a drug-drug interaction. For example, NSAIDs thin the blood. If you take a blood thinning medicine such as warfarin and you take an NSAID, there could be a drug-drug interaction. Vitamins and herbal supplements can affect the way your body processes medicines, too. Certain foods or drinks can also prevent your medicine from working the way it should. Or they can make side effects worse. This is called a drug-food interaction. For example, if you’re taking a traditional NSAID, drinking alcohol can increase your risk of liver disease or stomach bleeding. Drug-drug interactions and drug-food interactions can be dangerous. Be sure that your doctor knows all of the medicines you are taking. This includes OTC and prescription medicines, vitamins, and herbal supplements. Also, talk to your doctor before you take any new OTC or prescription medicine, vitamin, or supplement. It’s important to take medicines exactly as your doctor prescribes. Ask your doctor whether you need to avoid any foods or drinks while using a prescription NSAID. Questions to ask your doctor
Non-steroidal anti-inflammatory drugs (NSAIDs) are medicines that are widely used to relieve pain, reduce inflammation, and bring down a high temperature. They're often used to relieve symptoms of headaches, painful periods, sprains and strains, colds and flu, arthritis, and other causes of long-term pain. Although NSAIDs are commonly used, they're not suitable for everyone and can sometimes cause troublesome side effects. This information is a general overview of NSAIDs. For information about a specific medicine, you can look up your medicine on our Medicines A-Z.
There have been some news reports of anti-inflammatory painkillers, such as ibuprofen, making coronavirus worse. The Commission on Human Medicines has now confirmed there is no clear evidence that using ibuprofen to treat symptoms such as a high temperature makes coronavirus worse. You can take paracetamol or ibuprofen to treat symptoms of coronavirus. Try paracetamol first if you can, as it has fewer side effects than ibuprofen and is the safer choice for most people. Always follow the instructions that come with your medicine. NSAIDs are available as tablets, capsules, suppositories (capsules inserted into the bottom), creams, gels and injections. Some can be bought over the counter from pharmacies, while others need a prescription. The main types of NSAIDs include: NSAIDs may be sold or prescribed under these names or a brand name. They're all similarly effective, although you may find a particular one works best for you. Most people can take NSAIDs, but some people need to be careful about taking them. It's a good idea to ask a pharmacist or doctor for advice before taking an NSAID if you:
NSAIDs might not necessarily need to be avoided in these cases, but they should only be used on the advice of a healthcare professional as there may be a higher risk of side effects. If NSAIDs are not suitable, your pharmacist or doctor may suggest alternatives to NSAIDs, such as paracetamol. Like all medicines, there's a risk of side effects from NSAIDs. These tend to be more common if you're taking high doses for a long time, or you're elderly or in poor general health. Over-the-counter NSAIDs generally have fewer side effects than stronger prescription medicines. Possible side effects of NSAIDs include: If you get any troublesome side effects, stop taking your medicine and tell your doctor. Some NSAIDs can react unpredictably with other medicines. This can affect how well either medicine works and increase the risk of side effects. It's particularly important to get medical advice before taking an NSAID if you're already taking: If you're not sure whether a medicine you're taking is safe to take at the same time as an NSAID, check the leaflet that comes with it, or ask a pharmacist or doctor for advice. The leaflet that comes with your medicine should say whether you need to avoid any particular foods or drinks. Ask your pharmacist or doctor if you're not sure. For information about a specific medicine, check the A-Z of medicine leaflets on the GOV.UK website. Generally, you do not need to avoid any specific foods while taking NSAIDs. Tablets or capsules should normally be swallowed whole and without chewing with water or food to stop them upsetting your stomach. It's usually safe to drink alcohol while taking NSAIDs, but drinking alcohol excessively may irritate your stomach. Taking too much of an NSAID can be dangerous. This is known as taking an overdose. Contact your GP or NHS 111 for advice immediately if you take too much of your medicine and you experience problems such as feeling or being sick, an upset stomach or drowsiness. Call 999 for an ambulance immediately if you or someone else experiences serious effects of an overdose, such as fits (seizures), breathing difficulties, or loss of consciousness. As NSAIDs can cause troublesome side effects, alternatives are often recommended first. The main alternative for pain relief is paracetamol, which is available over the counter and is safe for most people to take. NSAID creams and gels that you rub into your skin may be worth trying first if you have muscle or joint pain in a particular part of your body, as they tend to have fewer side effects than tablets or capsules. Your doctor may also be able to recommend different medicines and therapies depending on the health problem you have. For example, physiotherapy may help some people with muscle or joint pain.
Page last reviewed: 27 February 2019 |
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