Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that reduce fever, pain, and inflammation. They include a large group of anti-inflammatory agents that work by inhibiting the production of prostaglandins (chemicals in the body that cause inflammation). As their name indicates, these drugs do not contain steroids such as prednisone, nor do they contain narcotics. NSAIDs are widely used as painkillers and as therapies for arthritis. Examples of NSAIDs include aspirin, ibuprofen, naproxen, ketoprofen, piroxicam, sulindac, choline subsalicylate, diflunisal, fenoprofen, indomethacin, meclofenamate salsalate, tolmetin, magnesium salicylate, and nabumetone, to name just a few.
Prostaglandins
Chemicals that produce pain and inflammation.
Acetaminophen (brand name: Tylenol) is not an NSAID. It has a different chemical composition and does not cause the same side effects as the NSAIDs—that is, it won't irritate your stomach the way that NSAIDs such as aspirin, naproxen sodium, or even ibuprofen sometimes can.
NSAIDs are considered safe medications. In fact, many—such as ibuprofen and aspirin—are available without a prescription (over the counter). Even so, they can cause ill effects in some people who take them. In particular, NSAIDs can cause ulcers, gastrointestinal bleeding, rashes, kidney problems, and liver dysfunction. These problems usually occur in people who take doses higher than the recommended range or who take these medications for a long time, although side effects can sometimes occur after taking a single dose in the recommended range.
As mentioned earlier, the NSAIDs work by affecting the prostaglandins, which cause inflammation in the body. Unfortunately, the same group of chemicals is involved in the stomach; thus the NSAIDs tend to cause indigestion, and may even cause ulcers and bleeding in the stomach and intestines.
NSAIDs should not be used by people who have a history of stomach or intestinal ulcers, those with bleeding disorders, or those who are taking blood thinners such as heparin or warfarin (Coumadin). If you fall into one of these categories but think you need to take an NSAID, discuss it with your physician first.
NSAIDs vary in terms of their strength and side effects. As with many medications, there is a relationship between a particular NSAID's potency and its tendency to produce side effects. For this reason, you should use these drugs with care. Take the smallest possible dose that is effective, and take no more than the maximal daily dose recommended by your physician or the product's manufacturer. In some people, NSAIDs can cause allergic reactions such as rashes, lip swelling, nasal congestion, shortness of breath, or worsening of asthma symptoms. Notify your physician if you've had an allergic reaction to aspirin or any other NSAID.
While taking NSAIDs, you should notify your physician if you have any of the following symptoms, as they may indicate a drug side effect:
- Stomach pain
- Indigestion
- Nausea or vomiting
- Dark or black stool
- Weakness
- Shortness of breath
- Rash
- Swelling of the face or extremities
Before you begin taking NSAIDs regularly, your doctor may want to do some blood tests, including a complete blood count (CBC) to make sure you are not anemic. Your physician will also perform blood tests to evaluate your liver and kidney function—in rare cases, NSAIDs can cause liver and kidney dysfunction. These tests should be repeated every year while you're taking NSAIDs or more frequently if you are having any symptoms.