NSAIDs Overview

What Are NSAIDs?

Non-steroidal anti-inflammatory drugs (NSAIDs) reduce pain, inflammation, and fever. They work by blocking enzymes (COX-1 and COX-2) that produce prostaglandins, chemicals involved in inflammation and pain signaling. They're among the most commonly used medications worldwide.¹

Common NSAIDs²

Over-the-Counter

Ibuprofen (Advil, Motrin)
Naproxen (Aleve)
Aspirin

Prescription

Celecoxib (Celebrex): COX-2 selective
Meloxicam (Mobic)
Diclofenac (Voltaren)
Indomethacin
Ketorolac: Short-term use only

How They Help

Reduce inflammation
Decrease pain
Lower fever
Work for many pain types

Best For

Arthritis (inflammatory)
Acute injuries
Headaches
Menstrual pain
Post-surgical pain
Inflammatory conditions

Risks and Side Effects³

Gastrointestinal

Stomach upset, heartburn
Ulcers
GI bleeding (can be serious)
Risk increases with age and duration

Cardiovascular

Increased heart attack risk
Increased stroke risk
Higher with longer use and higher doses
COX-2 inhibitors have higher CV risk

Kidney

Can affect kidney function
Risk higher in kidney disease, dehydration
Can raise blood pressure

Safe Use Guidelines

Use lowest effective dose
Shortest duration possible
Take with food
Stay hydrated
Don't combine different NSAIDs
Monitor for side effects

Who Should Be Cautious

History of GI bleeding or ulcers
Heart disease or risk factors
Kidney disease
Taking blood thinners
Older adults
Pregnant women (especially 3rd trimester)

Long-Term Use Considerations

Regular monitoring may be needed
Consider gastroprotection (PPI)
Discuss risks vs. benefits with doctor
May need periodic breaks

References

Sostres C, Gargallo CJ, Arroyo MT, Lanas A. Adverse effects of non-steroidal anti-inflammatory drugs. Dig Liver Dis. 2010;42(4):250-259.
Chou R, McDonagh MS, Nakamoto E, Griffin J. Analgesics for Osteoarthritis: An Update of the 2006 Comparative Effectiveness Review. AHRQ Comparative Effectiveness Reviews. 2011.
Bhala N, Emberson J, Merhi A, et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs. Lancet. 2013;382(9894):769-779.