Nonsteroidal Anti-inflammatory Drugs

A group of drugs that are used to relieve pain and inflammation, particularly in muscles, ligaments, and joints

Common drugs

  • Acemetacin

  • Aspirin

  • Diclofenac

  • Etodolac

  • Fenbufen

  • Fenoprofen

  • Flurbiprofen

  • Ibuprofen

  • Indometacin

  • Ketoprofen

  • Mefenamic acid

  • Meloxicam

  • Nabumetone

  • Naproxen

  • Piroxicam

  • Sulindac

  • Tenoxicam

  • Tiaprofenic acid

    COX-2 inhibitors

  • Celecoxib

  • Etoricoxib

Nonsteroidal anti-inflammatory drugs (NSAIDs) are nonopioid painkillers that are used to relieve the discomfort and inflammation caused by a variety of musculoskeletal disorders. These drugs are also commonly used to treat other types of pain and inflammation, such as headache.

Although it is technically an NSAID, aspirin is not usually classed with other types of NSAID because it has only a limited anti-inflammatory effect at normal doses. For this reason, NSAIDs with a more powerful anti-inflammatory action are normally prescribed to treat inflammatory conditions.

NSAIDs may be used for conditions that develop suddenly, such as ligament damage and muscle strains and tears. They usually reduce symptoms within a few hours. NSAIDs are also used to relieve pain and inflammation caused by long-term musculoskeletal disorders, such as osteoarthritis and rheumatoid arthritis. When used to treat these conditions, NSAIDs can rapidly relieve pain, but they may take about 2 weeks to reduce inflammation. Although NSAIDs are effective in alleviating symptoms, they do not cure the underlying condition.

NSAIDs reduce pain and inflammation by blocking the action of the enzyme cyclo-oxygenase (COX), which is involved in the production of prostaglandins, substances that trigger inflammation and the transmission of pain signals to the brain but which also protect the stomach lining. There are two types of COX, COX-1 and COX-2, which act at different sites in the body. Most NSAIDs block both COX-1 (leading to stomach irritation) and COX-2 (providing the anti-inflammatory effect). COX-2 inhibitors block COX-2 alone, thereby reducing the risk of stomach irritation.

How are they used?

NSAIDs are most commonly taken orally, although occasionally they may be applied as a gel or given by injection. Certain NSAIDs are available in a slow-release form, which may be effective for up to 24 hours. This reduces the need to take pills frequently when long-term conditions are being treated. Slow-release NSAIDs also provide a more constant level of pain relief. For many conditions, these drugs are used in combination with other treatments, such as physiotherapy. Some NSAIDs, such as ibuprofen, can be bought over the counter.

What are the side effects?

NSAIDs have varying potential to irritate the stomach lining, which may cause nausea, indigestion, bleeding from the stomach, and occasionally peptic ulcer. If you are given certain NSAIDs, such as ibuprofen, for long-term use, you may also be given an anti-ulcer drugs (see Ulcer-healing drugs) to protect the stomach lining. COX-2 inhibitors cause less stomach irritation than other NSAIDs but, because they are associated with an increased risk of heart disease and stroke, they are not generally recommended for people who have had, or who are at risk of having these conditions. Some other NSAIDs, such as diclofenac and ibuprofen, when used at high doses for long periods, may also increase the risk of heart disease and stroke. Consequently, NSAIDs should be used at the lowest effective dose for the shortest period.

NSAIDs may also cause allergic reactions (see Drug allergy), including rashes and a condition called angioedema, in which temporary, painless swellings develop in the skin and mucous membranes. People who have had a reaction to any NSAID should avoid all NSAIDs. Some people may develop photosensitivity, in which the skin becomes abnormally sensitive to sunlight. People who have asthma or a kidney disorder may be advised not to take NSAIDs because the drugs can make these conditions worse.

Drug Action: How NSAIDs Work

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

The subjects, conditions and treatments covered in this encyclopaedia are for information only and may not be covered by your insurance product should you make a claim.

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