Arthritis Health Center

Making the Decision on NSAIDs

Experts agree that, for most people, there's no harm in taking nonsteroidal anti-inflammatory pain relievers, called NSAIDs, for the occasional headache, fever, or muscle ache. Indeed, on any given day more than 30 million Americans use NSAIDs to soothe headaches, sprains, arthritis symptoms, and other daily discomforts, according to the American Gastroenterological Association.

But these useful pain relievers also raise the risk of ulcers and heart problems in some people. Should you take an NSAID every day if you have arthritis or chronic pain?

To help you understand the pros and cons, WebMD turned to four experts for advice:

• Byron Cryer, MD, a gastroenterologist, spokesman for the American Gastroenterological Association, and an associate professor of medicine at the University of Texas Southwestern Medical Center in Dallas.
• Nieca Goldberg, MD, a cardiologist, spokeswoman for the American Heart Association, and chief of Women's Cardiac Care at Lennox Hill Hospital in New York.
• John Klippel, MD, a rheumatologist and president & CEO of the Arthritis Foundation in Atlanta.
• Scott Zashin, MD, a rheumatologist and clinical assistant professor at the University of Texas Southwestern Medical Center in Dallas.

Here is the information they gave to help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation. If you already know this basic information, you can jump directly to your NSAID decision worksheet and begin assessing the pros and cons as they apply to you.

Key Points in Making the NSAID Decision

Consider the following when making your decision:

• NSAIDs (nonsteroidal anti-inflammatory drugs) are a common class of over-the-counter and prescription painkiller. Examples include aspirin, Advil, Aleve, Motrin, and prescription drugs like Celebrex.
  
  
• You should never take any over-the-counter medicine regularly without discussing it with your doctor. Most over-the-counter painkillers should not be used for more than 10 days.
  
  
• Like any medicine, over-the-counter and prescription NSAIDs have side effects. The FDA has recently required that all over-the-counter and prescription NSAIDs -- except aspirin -- include warnings about possible risks of gastrointestinal and cardiovascular side effects and allergic reactions.
  
  
• The risks of NSAIDs have been highlighted in the media recently. But it's important to understand that, for many people, NSAIDs are a safe and effective treatment. The key is to work with your doctor. Together, you can weigh the benefits and risks and decide on the best treatment in your case.
  
  
• NSAIDs are not alike. They can have very different pros and cons. Talk to your doctor about the NSAID that might work best for you.
  
  
• NSAIDs can appear in unlikely places. For instance, many over-the-counter medicines for colds and the flu contain doses of these pain relievers. Make sure you know the ingredients of any medicine you use.
  
  
• There are alternatives to NSAIDs. Many people who can't take NSAIDs benefit from Tylenol (acetaminophen.) Other options for people with severe chronic pain are prescription narcotics, like OxyContin, Percocet, and Vicodin. Some find that physical therapy, weight loss (if overweight), biofeedback, yoga, meditation, and acupuncture can also reduce their pain.
  
  
• In some people, complete pain relief isn't possible. But in such cases, you can focus on reducing your pain so that it doesn't interfere with your life.