Nonsteroidal anti-inflammatory drugs (NSAIDs)

Anti inflammatory drugs (NSAIDS)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of medications that are used to reduce inflammation and relieve pain. They are a common first line treatment for many conditions including sprains and strains, spinal stenosis, and inflammatory conditions like rheumatoid arthritis and ankylosing spondylitis. They work by blocking the production of certain chemicals in the body called prostaglandins, which are involved in the inflammation and pain response.

Examples of NSAIDs

There are many different types of NSAIDs available, both over-the-counter (OTC) and by prescription. Some examples include:

  • Aspirin
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve)
  • Diclofenac (Voltaren)
  • Celecoxib (Celebrex)

Time to Onset

For over-the-counter NSAIDs, such as ibuprofen and naproxen, relief of pain and inflammation may be noticed within 30 minutes to an hour after taking the medication. The full effects may take up to 2 hours to be felt.

For prescription NSAIDs, such as celecoxib, the onset of action may take longer, usually around 2-3 hours.

Duration of Action

The duration of action of different NSAIDs can vary depending on the specific medication, dosage, and individual. Here is a general idea for some commonly used NSAIDs:

  • Aspirin: The duration of action for aspirin can vary from 4 to 8 hours.
  • Ibuprofen: The duration of action for ibuprofen is typically 4 to 6 hours, with some studies showing effects lasting up to 8 hours.
  • Naproxen: The duration of action for naproxen is typically 12 to 24 hours, with some studies showing effects lasting up to 36 hours.
  • Diclofenac: The duration of action for Diclofenac is typically 12 to 24 hours.
  • Celecoxib: The duration of action for celecoxib is typically 24 hours.

Side Effects of NSAIDs

While NSAIDs are generally considered safe when used as directed, they can cause side effects, some of them can be severe. Some of the most common side effects of NSAIDs include:

  • Stomach upset, such as indigestion, heartburn, and stomach ulcers.
  • Increased risk of bleeding
  • Kidney damage
  • Cardiovascular risk, particularly in people with heart disease, high blood pressure, or a history of stroke

It’s important to note that some people may be at higher risk of experiencing side effects from NSAIDs. People with a history of stomach or intestinal bleeding, or who are taking blood-thinning medications, should be particularly cautious when using these drugs.

Who should avoid taking NAIDs?

Some people should avoid using non-steroidal anti-inflammatory drugs (NSAIDs) due to an increased risk of side effects. These include people who:

  • Have a history of stomach ulcers, bleeding or other gastrointestinal issues
  • Have a history of heart disease, high blood pressure, kidney or liver disease
  • Are pregnant
  • Have a history of allergic reactions to NSAIDs
  • Are taking blood-thinning medication such as warfarin or aspirin
  • Are taking medication for high blood pressure or heart failure
  • Are older adults, as they may be at a higher risk of complications

Additionally, if you’re planning to have any surgery, you should stop taking nsaids at least a week before the operation.

Over-the-counter (OTC) vs Prescription NSAIDs

The main difference between over-the-counter (OTC) and prescription non-steroidal anti-inflammatory drugs (NSAIDs) is the strength and potency of the medication.

Over-the-counter NSAIDs, such as ibuprofen and naproxen, are available without a prescription and are typically used for mild to moderate pain and inflammation. They are usually taken at lower doses than prescription NSAIDs and are intended for short-term use, usually no more than a few days.

Prescription NSAIDs, such as celecoxib and diclofenac, are only available with a prescription from a doctor and are typically used for moderate to severe pain and inflammation. They are usually taken at higher doses than over-the-counter NSAIDs and are intended for long-term use, usually several weeks or months.

Symptoms to Tell Your Doctor About

If you are taking non-steroidal anti-inflammatory drugs (NSAIDs), it is important to inform your doctor if you experience any of the following symptoms:

  • Stomach pain, heartburn, or indigestion
  • Blood in your urine or bowel movements
  • Black or tarry stools
  • Shortness of breath or chest pain
  • Unusual weight gain or swelling in the legs or arms
  • Skin rash, hives, or itching
  • Swelling of the face, lips, tongue, or throat
  • Yellowing of the skin or eyes (jaundice)

Are NSAIDs right for me?

To determine if NSAIDs are right for you, it is important to speak with a healthcare professional, such as a doctor or pharmacist, who can assess your individual needs and medical history. They will take into account factors such as:

  • The type and severity of your pain or inflammation
  • Any other medical conditions you may have
  • Any other medications you are currently taking
  • Your risk for side effects
  • Your age and overall health

Whether NSAIDs are right for you depends on your individual situation and the condition being treated.

About the Author

Dave Harrison, MD

Dr. Harrison is a board certified Emergency Physician with a part time appointment at San Francisco General Medical Center and is an Assistant Clinical Professor-Volunteer at the UCSF School of Medicine. Dr. Harrison attended medical school at Tufts University and completed his Emergency Medicine residency at the University of Southern California. Dr. Harrison manages the editorial process for