- Rheumatoid Arthritis Slideshow Pictures
- Joint-Friendly Exercises to Reduce RA Pain Slideshow
- Take the RA Quiz
- Aspirin vs. NSAIDs side effects differences
- What is aspirin an NSAID? What are NSAIDs? How do they work (mechanism of action)?
- What are the uses for aspirin vs. NSAIDs?
- What are the side effects of aspirin vs. NSAIDs?
- What are the drug interactions for aspirin vs. NSAIDs?
- Are there any differences between NSAIDs?
Aspirin vs. NSAIDs side effects differences
- Aspirin is a type of nonsteroidal anti-inflammatory drug (NSAID). NSAIDs are non-narcotic pain relievers.
- Aspirin and other NSAIDs are used to treat pain and reduce inflammation from a variety of causes, such as headaches, injuries, arthritis, menstrual cramps, and muscle aches. NSAIDs also are used as fever reducers.
- Aspirin also prevents blood clots (i.e., is antithrombotic).
- Other examples of NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), oxaprozin (Daypro), and piroxicam (Feldene).
- The most common side effects of aspirin and NSAIDs are gastrointestinal (GI), and include:
- Other side effects of aspirin and NSAIDs include:
- Serious side effects of aspirin and NSAIDs include:
- Kidney or liver failure
- Serious gastrointestinal bleeding
- Prolonged bleeding after surgery
- Children and teenagers who have or are recovering from chickenpox or the flu should not take aspirin or other NSAIDs because of the risk of developing Reye's Syndrome, a rare and serious illness of the liver and nervous system that can lead to coma and death.
What is aspirin an NSAID? What are NSAIDs? How do they work (mechanism of action)?
Aspirin is type of nonsteroidal anti-inflammatory drug (NSAID) effective in treating fever, pain, and inflammation in the body. It also prevents blood clots (i.e., is antithrombotic).
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat pain and reduce inflammation from a variety of causes, such as headaches, injuries, arthritis, menstrual cramps, and muscle aches. NSAIDs are also used as fever reducers.
NSAIDs work by blocking two forms of an enzyme called cyclooxygenase (COX). COX-1 protects the stomach lining from digestive acids, and helps maintain kidney function. COX-2 is produced when joints are injured or inflamed. Blocking both forms of this enzyme reduces inflammation, pain, and fever, but can also cause gastrointestinal side effects.
What are the uses for aspirin vs. NSAIDs?
Aspirin is used for the treatment of inflammation, fever, and pain that results from many forms of arthritis, including:
- Rheumatoid arthritis
- Juvenile rheumatoid arthritis
- Systemic lupus erythematosus
- Ankylosing spondylitis
- Reiter's syndrome
- Soft tissue injuries, such as tendinitis and bursitis
Aspirin also is used for rapid relief of mild to moderate pain and fever in other inflammatory conditions. Because aspirin inhibits the function of platelets for prolonged periods of time, it is used for reducing the risk of another stroke or heart attack in people who have already had a stroke or heart attack.
- NSAIDs are used primarily to treat inflammation, mild to moderate pain, and fever.
- Specific uses include the treatment of headaches, arthritis, ankylosing spondylitis, sports injuries, and menstrual cramps.
- Ketorolac (Toradol) is only used for short-term treatment of moderately severe acute pain that otherwise would be treated with narcotics.
- Aspirin (also an NSAID) is used to inhibit the clotting of blood and prevent strokes and heart attacks in individuals at high risk for strokes and heart attacks.
- NSAIDs also are included in many cold and allergy preparations.
- Celecoxib (Celebrex) is used for treating familial adenomatous polyposis (FAP) to prevent the formation and growth of colon polyps.
What are the side effects of aspirin vs. NSAIDs?
Side effects of aspirin
Most patients benefit from aspirin and other NSAIDs with few side effects. However, serious side effects can occur and generally tend to be dose-related. Therefore, it is advisable to use the lowest effective dose to minimize side effects.
The most common side effects of aspirin involve the gastrointestinal system and ringing in the ears.
Gastrointestinal (GI) side effects include:
- abdominal burning,
- gastritis, and
- even serious gastrointestinal bleeding, and
- liver toxicity.
Ringing in the ears
Should ringing in the ears occur, the daily dose should be reduced.
Other side effects of aspirin include:
Other side effects and adverse reactions of aspirin
- Aspirin should be avoided by patients with peptic ulcer disease or poor kidney function, since this medication can aggravate both conditions.
- Aspirin may exacerbate asthma.
- Aspirin can raise the blood uric acid level and is avoided in patients with hyperuricemia and gout.
- Children and teenagers should avoid aspirin for symptoms of the flu or chickenpox because of the associated risk of Reye's Syndrome, a serious disease of the liver and nervous system that can lead to coma and death.
- Aspirin can increase the effect of medicines used to treat diabetes mellitus, resulting in abnormally low blood sugars if blood sugar levels are not monitored.
- NSAIDs should be discontinued prior to elective surgery because of a mild tendency to interfere with blood clotting. Aspirin, because of its prolonged effect on platelets, is best discontinued at least ten to fourteen days in advance of the procedure.
Side effects of NSAIDs
NSAIDs are associated with several side effects. The frequency of side effects varies among NSAIDs.
Common side effects of NSAIDs are
Other important side effects are:
- kidney failure (primarily with chronic use),
- liver failure,
- ulcers, and
- prolonged bleeding after injury or surgery.
NSAIDs can cause fluid retention which can lead to edema, which is most commonly manifested by swelling of the ankles.
WARNING: Some individuals are allergic to NSAIDs and may develop shortness of breath when an NSAID is taken. People with asthma are at a higher risk for experiencing serious allergic reaction to NSAIDs. Individuals with a serious allergy to one NSAID are likely to experience a similar reaction to a different NSAID.
Use of aspirin in children and teenagers with chickenpox or influenza has been associated with the development of Reye's syndrome, a serious and sometimes fatal liver disease. Therefore, aspirin and non-aspirin salicylates (for example, salsalate [Amigesic]) should not be used in children and teenagers with suspected or confirmed chickenpox or influenza.
NSAIDs increase the risk of potentially fatal, stomach and intestinal adverse reactions (for example, bleeding, ulcers, and perforation of the stomach or intestines). These events can occur at any time during treatment and without warning symptoms. Elderly patients are at greater risk for these adverse events. NSAIDs (except low dose aspirin) may increase the risk of potentially fatal heart attacks, stroke, and related conditions. This risk may increase with duration of use and in patients who have underlying risk factors for heart and blood vessel disease. Therefore, NSAIDs should not be used for the treatment of pain resulting from coronary artery bypass graft (CABG) surgery.
What are the drug interactions for aspirin vs. NSAIDs?
Aspirin drug interactions
Aspirin is associated with several suspected or probable interactions that affect the action of other drugs. The following examples are the most common of the suspected interactions.
Aspirin may reduce the blood pressure lowering effects of blood pressure medications. This may occur because prostaglandins have a role in the regulation of blood pressure.
When aspirin is used in combination with methotrexate (Rheumatrex, Trexall) or aminoglycoside antibiotics (for example, gentamicin) the blood levels of the methotrexate or aminoglycoside may increase, presumably because their elimination from the body is reduced. This may lead to more methotrexate or aminoglycoside-related side effects.
Individuals taking oral blood thinners or anticoagulants, for example, warfarin, (Coumadin) should avoid aspirin because aspirin also thins the blood, and excessive blood thinning may lead to serious bleeding.
NSAID drug interactions
NSAIDs reduce blood flow to the kidneys and therefore reduce the action of diuretics ("water pills") and decrease the elimination of lithium (Eskalith, Lithobid) and methotrexate (Rheumatrex, Trexall). As a result, the blood levels of these drugs may increase as may their side effects.
NSAIDs also decrease the ability of the blood to clot and therefore increase bleeding. When used with other drugs that also increase bleeding (for example, warfarin [Coumadin]), there is an increased likelihood of serious bleeding or complications of bleeding. Therefore, individuals who are taking drugs that reduce the ability of blood to clot should avoid prolonged use of NSAIDs.
NSAIDs increase the negative effect of cyclosporine on kidney function.
Persons who have more than three alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking NSAIDs.
Are there any differences between NSAIDs?
NSAIDs vary in their potency, duration of action, how they are eliminated from the body, how strongly they inhibit COX-1 versus COX-2 and their tendency to cause ulcers and promote bleeding. The more an NSAID blocks COX-1, the greater is its tendency to cause ulcers and promote bleeding. One NSAID, celecoxib (Celebrex), blocks COX-2 but has little effect on COX-1, and is therefore further classified as a selective COX-2 inhibitor. Selective COX-2 inhibitors cause less bleeding and fewer ulcers than other NSAIDs.
Aspirin is a unique NSAID, not only because of its many uses, but because it is the only NSAID that inhibits the clotting of blood for a prolonged period of time (4 to 7 days). This prolonged effect of aspirin makes it an ideal drug for preventing blood clots that cause heart attacks and strokes.
Most NSAIDs inhibit the clotting of blood for only a few hours. Ketorolac (Toradol) is a very potent NSAID and is used for moderately severe acute pain that usually requires narcotics. Ketorolac causes ulcers more frequently than other NSAID. Therefore, it is not used for more than five days. Although NSAIDs have a similar mechanism of action, individuals who do not respond to one NSAID may respond to another.
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Aspirin and nonsteroidal anti-inflammatory drugs, or NSAIDs, are both drugs
used to treat pain, redness, swelling, and inflammation from a variety of
medical conditions like menstrual cramps, arthritis, minor strains and sprains,
and headaches. Aspirin also treats fever. Aspirin also is an NSAID, but it works
in the body differently than other NSAIDs.
Some of the common side effects of aspirin and NSAIDS are nausea, vomiting, diarrhea, constipation, loss of appetite, peptic ulcers, and tinnitus. NSAIDs also can cause dizziness, headache, and drowsiness. Important and serious side effects of both drugs are kidney or liver failure, GI bleeding, and prolonged bleeding after surgery.
Aspirin and nonsteroidal anti-inflammatory drugs have other important side effects and drug interactions that should be reviewed prior to taking either drug.
REFERENCE: FDA. Medication Guide for Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).
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Related Disease Conditions
Acute injuries, medical conditions, and chronic use conditions are causes of knee pain. Symptoms and signs that accompany knee pain include redness, swelling, difficulty walking, and locking of the knee. To diagnose knee pain, a physician will perform a physical exam and also may order X-rays, arthrocentesis, blood tests, or a CT scan or MRI. Treatment of knee pain depends upon the cause of the pain.
Lower Back Pain (Lumbar Spine Pain)
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis, and abdomen, and the skin covering the lumbar area.
Sore throat (throat pain) usually is described as pain or discomfort in the throat area. A sore throat may be caused by bacterial infections, viral infections, toxins, irritants, trauma, or injury to the throat area. Common symptoms of a sore throat include a fever, cough, runny nose, hoarseness, earaches, sneezing, and body aches. Home remedies for a sore throat include warm soothing liquids and throat lozenges. OTC remedies for a sore throat include OTC pain relievers such as ibuprofen or acetaminophen. Antibiotics may be necessary for some cases of sore throat.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Early RA signs and symptoms include anemia, both sides of the body affected (symmetric), depression, fatigue, fever, joint deformity, joint pain, joint redness, joint stiffness, joint swelling, joint tenderness, joint warmth, limping, loss of joint function, loss of joint range of motion, and polyarthritis.
What Is the Safest Anti-Inflammatory to Take?
Non-steroidal anti-inflammatory drugs or NSAIDs are some of the most commonly used medicines available. Experts say that taking NSAIDs for a short time at the lowest effective dose is generally safe.
Although a fever technically is any body temperature above the normal of 98.6 F (37 C), in practice, a person is usually not considered to have a significant fever until the temperature is above 100.4 F (38 C). Fever is part of the body's own disease-fighting arsenal; rising body temperatures apparently are capable of killing off many disease-producing organisms.
Shoulder and Neck Pain
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Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
Arthritis (Joint Inflammation)
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, and pseudogout.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of cartilage in the joints. Also known as degenerative arthritis, osteoarthritis can be caused by aging, heredity, and injury from trauma or disease.
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Spider Bites (Black Widow and Brown Recluse)
Most spiders in the United States are harmless; however, black widow and brown recluse spider bites may need medical treatment. Symptoms of a harmless spider bite generally include pain, redness, and irritation. Signs and symptoms of black widow spider bite include pain immediately, redness, burning, and swelling at the site of the bite. Sometimes the person will feel a pinprick or double fang marks. Brown recluse spider bite symptoms and signs are a mild sting, followed by severe pain and local redness. These symptoms usually develop within eight hours or more after the bite. Black widow and brown recluse spider bites have similar symptoms, for example, nausea, vomiting, fever, headache, and abdominal or joint pain. Generally, brown recluse and black widow spider bites need immediate medical treatment. If you think that you or someone you know has been bitten by a brown recluse or black widow spider, go to your nearest Urgent Care or Emergency Department for medical treatment.
Ankle Pain (Tendonitis)
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
Neck Pain (Cervical Pain)
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Menstrual Cramps and PMS (Premenstrual Syndrome) Treatment
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Prostatitis and BPH (benign prostatic hyperplasia, enlarged prostate gland) are both conditions of the prostate gland. There are four types of prostatitis that can be caused by infections (usually bacterial) or other health conditions or problems, acute bacterial prostatitis (type I), chronic bacterial prostatitis (type II), chronic prostatitis and chronic pelvic pain syndrome (type III), and asymptomatic inflammatory prostatitis (type IV). BPH is inflammation of the prostate gland, and most men have the condition by age 50. Doctor's don't know what causes this inflammation, but they theorize that it may be related to hormones. Both of these conditions can cause similar symptoms like low back pain, pain during urination, or difficulty or the inability to urinate. However, prostatitis has many more symptoms and signs than BPH, and they based on the type of prostatitis. Examples include low back pain and/or abdominal pain, painful urination, fever, chills, feeling tired, recurrent urinary tract infections (UTIs), painful urination intermittently, intermittent obstruction urinary tract symptoms (frequent, painful, or incomplete urination), pelvic pain and/or discomfort, pain with ejaculation, and erectile dysfunction (ED). If you think you have either of these conditions contact your doctor or other health care professional. Bacterial prostatitis can be cured with antibiotics; however, there is no cure for BPH.
Arthritis, bursitis, IT band syndrome, fracture, and strain are just some of the causes of hip pain. Associated symptoms and signs include swelling, tenderness, difficulty sleeping on the hip, and loss of range of motion of the hip. Treatment depends upon the cause of the hip pain but may include anti-inflammatory medications and icing and resting the hip joint.
Migraines and Seizures (Symptoms, Auras, Medication)
Migraines are a type of headache and seizures are the main symptom of epilepsy. Migraine headaches and seizures are two different neurological problems that have similar signs, symptoms, and auras, for example, sensitivity to light (photophobia) and sound, irritability, nausea, and vomiting. Symptoms unique to migraine and migraine auras are water retention, problems sleeping, appetite changes, and talkativeness. Symptoms unique to seizure and seizures auras are depression, a feeling of heaviness, a feeling that a seizure is approaching, and depression. Many of the symptoms of migraine and seizures are the same, however, seizures do not cause migraines; however, people who have seizures are twice as likely to have migraines and vice-versa. People who have migraines are twice as likely to have seizures, and people with seizures are twice as likely to have migraines; however, one condition does not cause the other.
Osteoarthritis vs. Osteoporosis Differences and Similarities
Arthritis is defined as painful inflammation and joint stiffness. Osteoarthritis is a type of arthritis and the most common cause of chronic joint pain, affecting over 25 million Americans. Osteoarthritis is a type of arthritis that involves the entire joint. Osteoporosis is not a type of arthritis. It is a disease that mainly is caused by a loss of bone tissue that is not limited to the joint areas. It is possible for one person to have both osteoarthritis and osteoporosis. The differences in the signs and symptoms of osteoarthritis and osteoporosis include; pain, stiffness, and joint swelling, joint deformity, crackle sounds when the joint is moving, and walking with a limp. Osteoporosis is called the "silent disease" because it can progress for years without signs and symptoms before it is diagnosed, severe back pain, bone fractures, height loss, and difficulty or inability to walk. The differences in the causes of osteoarthritis and osteoporosis are that osteoarthritis usually is caused by wear and tear on the joints. Osteoporosis usually is caused by one or more underlying problems, for example, calcium and vitamin D deficiencies. Treatment for osteoarthritis and osteoporosis are not the same. There is no cure for osteoarthritis or osteoporosis.
What Is the Life Expectancy of Someone with Crohn's Disease?
Crohn’s disease is a chronic condition that causes inflammation in the gut (digestive tract).Crohn’s disease belongs to a group of conditions known as inflammatory bowel disease (IBD). With appropriate management, patients with Crohn’s disease may expect a normal life expectancy and a good quality of life.
Menstrual cramps (pain in the belly and pelvic area) are experienced by women as a result of menses. Menstrual cramps are not the same as premenstrual syndrome (PMS). Menstrual cramps are common, and may be accompanied by headache, nausea, vomiting, constipation, or diarrhea. Severity of menstrual cramp pain varies from woman to woman. Treatment includes OTC or prescription pain relief medication.
Elbow pain is most often the result of tendinitis, which can affect the inner or outer elbow. Treatment includes ice, rest, and medication for inflammation. Inflammation, redness, warmth, swelling, tenderness, and decreased range of motion are other symptoms associated with elbow pain. Treatment for elbow pain depends upon the nature of the patient's underlying disease or condition.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Is There a Cure for Cirrhosis of the Liver?
Liver cirrhosis results from disease- or chemical-induced injury to the liver over a sustained period. The injury kills liver cells, and your body attempts to rebuild the damage. In the process, the existing cells are inflamed and scar tissue results, compromising the structure of the liver and hampering its function.
Pain Management: Musculoskeletal Pain
Natural menopause is the permanent ending of menstruation that is not brought on by any type of medical treatment. For women undergoing natural menopause, the process is described in three stages: perimenopause, menopause, and postmenopause. However, not all women undergo natural menopause. Some women experience induced menopause as a result of surgery or medical treatments, such as chemotherapy and pelvic radiation therapy.
Treatment & Diagnosis
Medications & Supplements
- Nonsteroidal Antiinflammatory Drugs (NSAIDs)
- aspirin (acetylsalicylic acid, Bayer, Ecotrin, and others)
- Aspirin vs. Plavix (clopidogrel)
- ibuprofen (Advil, Motrin, Nuprin)
- Aspirin vs. Aleve (Naproxen)
- celecoxib (Celebrex)
- Ketorolac vs. diclofenac
- naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
- ketorolac (Toradol)
- diclofenac, Voltaren, Cataflam, Voltaren-XR, Cambia
- piroxicam, Feldene
- indomethacin, Indocin, Indocin-SR (Discontinued Brand in U.S.)
- flurbiprofen (Ansaid)
- diclofenac and misoprostol (Arthrotec)
- Ketorolac vs. ketoprofen
- etodolac, Lodine (Discontinued)
- aspirin gum - oral, Aspergum
- diflunisal (Dolobid)
- methocarbamol/aspirin - oral
- aspirin suppository - rectal
- sulindac (Clinoril)
- oxaprozin (Daypro)
- butalbital/aspirin/caffeine - oral, Fiorinal
- hydrocodone and ibuprofen, Vicoprofen
- salsalate, Amigesic, Salflex, Argesic-SA, Marthritic, Salsitab, Artha-G
- orphenadrine/aspirin/caffeine - oral, Norgesic
- tolmetin (Tolectin [Discontinued Brand])
- Aspirin Therapy (Guidelines for Heart Attack and Stroke Prevention)
- aspirin/dipyridamole sustained-release - oral, Aggrenox
- narcotic analgesic/aspirin/caffeine - oral
- Norgesic (orphenadrine citrate, aspirin and caffeine)
Prevention & Wellness
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
AFDA. Aspirin patient information.
Academy of Orthopedic Surgeons. "What are NSAIDs?" Updated: Jan 2009.