Arthritis Health Center

Making the Decision on NSAIDs

What Are NSAIDs?

NSAIDs -- nonsteroidal anti-inflammatory drugs -- are a common treatment for ailments, such as joint pain, related to inflammation. They relieve pain, reduce swelling, and lower fevers.

Examples of over-the-counter NSAIDs are:

• Aspirin (Bayer, St. Joseph, and Ecotrin)
• Ibuprofen (Advil, Motrin, Nuprin)
• Ketoprofen (Actron, Orudis KT)
• Naproxen (Aleve)

There are also prescription strength NSAIDS. Some examples are Daypro, Indocin, Lodine, Naprosyn, Relafen, and Voltaren.

Cox-2 inhibitors are a newer form of prescription NSAID. Celebrex is the only one of these drugs still on the market. Two others -- Bextra and Vioxx -- are no longer sold because of concerns about their side effects.

How Do NSAIDs Work?

When you injure yourself, the damaged tissue releases certain chemicals. These chemicals cause the tissue to swell, and they amplify the feeling of pain. NSAIDs work by blocking the effects of these chemicals. As a result, you get less swelling and less pain.

What Are the Side Effects of NSAIDs?

The side effects -- and benefits -- of different NSAIDs vary. Here's a rundown of some of the more important risks.

• Heart attacks and strokes. Experts believe that all NSAIDs -- except aspirin -- have the potential to increase the risk of heart attacks and strokes. Celebrex may be the most likely to cause these effects. However, aspirin can lower the risks of heart attacks and strokes because it reduces the risk of blood clots.
  
  
• High blood pressure. All NSAIDs have the potential to raise high blood pressure. However, because aspirin has such good effects on the cardiovascular system, you doctor may ask that you take it especially if you are at risk for heart attack or stroke.
  
  
• Heartburn, ulcers, and gastrointestinal (GI) bleeding. Most NSAIDs increase the risk of GI problems. Celebrex is the NSAID least likely to cause problems because it was designed to avoid GI side effects.
  
  
• Kidney damage. NSAIDS can be damaging to the kidneys in some people.
  
  
• Allergic reactions. NSAIDs can cause allergic reactions, resulting in wheezing, hives, facial swelling, and shock. Dangerous side effects may be more common in people with asthma, especially if they also have sinus problems or nasal polyps -- tissue growths on the inside of the nasal cavity.

Other Warnings

• Many NSAIDs are not safe for pregnant women, especially in the last three months.
  
  
• Children and teenagers should not take aspirin because it's associated with the serious disease Reye's syndrome.
  
  
• Most over-the-counter and prescription pain relievers do not mix with alcohol. If you take an NSAID, including aspirin, just one drink a week can increase your risk of gastrointestinal bleeding. People who have three or more drinks a night should not use NSAIDs.

Your Decision on NSAIDs

Your choices are:

• To take NSAIDs on a regular basis
• Not to take NSAIDs on a regular basis

When deciding whether to use NSAIDs on a regular basis, you have to weigh both your personal feelings and the medical facts.