- What Is
- Dosing and Duration
- Allergic Reactions
- Stomach Issues
- Heart Disease and Stroke Risk
- Kidney Disease
- Alternative Treatments
If you have ever had a headache or pulled a muscle, you have probably headed to the medicine cabinet to reach for a pain killer. Over-the-counter pain medicines are affordable and safe for most people in the United States. They are so common that many people don't think twice about taking them to manage discomfort.
The most common pain medications are a class of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs). Like all medications, NSAIDs have risks, including stomach problems, allergic reactions, and an increased risk of heart attack. Your risk of complications from pain killers might increase depending on your age, what other medications you're taking, and your health in general.
Learn more about whether anti-inflammatory pain relievers are safe for you.
What are anti-inflammatory medications?
Non-steroidal anti-inflammatory drugs or NSAIDs are some of the most commonly used medicines available. This class of medications includes:
- Aspirin (full dose)
- Celecoxib (used in Celebrex)
- Diclofenac (used in Votaren)
- Ibuprofen (used in Advil or Motrin)
- Naproxen (used in Aleve)
Ibuprofen and naproxen are all available over the counter. Higher doses of ibuprofen and naproxen are available with a prescription. Celecoxib and diclofenac are only available with a prescription.
Aspirin is only considered an NSAID when taken at full dosage. Your doctor may recommend low-dose aspirin to reduce your risk of a heart attack. In the lower dose, aspirin doesn't pose the same health risk as full-strength NSAIDs.
These medicines are effective at dulling pain, reducing inflammation, and reducing fevers. When used moderately, they are generally considered safe. However, like any medication, they have potential risks.
Dosing and duration
Experts say that taking NSAIDs for a short time at the lowest effective dose is generally safe. If you have an injury or a fever, it is probably safe to take an over-the-counter NSAID to relieve symptoms. However, you should not exceed the recommended dose, and you should be cautious about how long you take pain medicine. Ask your doctor about the maximum daily amount you should take and how many days in a row it's safe to do so.
If you have long-term or chronic pain, talk to your doctor about whether NSAIDs are the best choice for treating you. There may be other options that would work better.
Allergic reactions to NSAIDs
Some people have rare but serious reactions to NSAIDs. Symptoms of an allergic reaction to NSAIDs can include:
- Swelling of the lips, tongue, or face
- Coughing, wheezing, or chest tightness
- Nasal congestion, or runny nose
- Red or watery eyes
If you have an allergic reaction to an anti-inflammatory medicine, you should talk to your doctor about it. You should avoid NSAIDs if you have ever had an allergic reaction to them in the past.
NSAIDs and stomach issues
The most common complication from NSAIDs is digestive problems. These medicines can give you minor stomach upset or indigestion. In more severe cases, people can develop gastritis, ulcers, or bleeding in the stomach or intestines.
The risk of stomach problems from NSAIDs goes up if you have other conditions or take certain medications. You may be high risk if you:
NSAIDs and heart disease and stroke risk
There is evidence that the use of non-aspirin NSAIDs can increase your risk of heart disease or stroke if you take them for a prolonged period of time. Higher doses are more likely to cause heart complications. The risk of heart-related complications from NSAIDs increases if you already have heart disease.
NSAIDs and kidney disease
If you already have reduced kidney function, you should avoid NSAIDs. The medications increase the risk that you will develop acute kidney failure. Talk to your doctor about whether you should take NSAIDs at all.
NSAIDs and pregnancy
The FDA recommends that you avoid NSAIDs after the 20th week of pregnancy. The medications can lead to rare but serious kidney problems in the developing fetus. They can also cause low amounts of amniotic fluid in the womb, which can lead to pregnancy complications.
If your doctor says you shouldn't take NSAIDs, ask what other medications you can use instead. For some people, acetaminophen (used in Tylenol) is a good alternative for pain management. Non-medication treatments such as heat or ice on injuries, physical therapy, or complementary medicine such as acupuncture may be appropriate.
If you have a condition that causes chronic pain, discuss your treatment options with your doctor. Prescription medications such as steroids, muscle relaxants, or opioids may be options to manage your condition.
Health Solutions From Our Sponsors
AAP News: "FDA warns pregnant women to avoid NSAIDs after 20 weeks."
Brigham and Women's Aspirin/NSAID Allergy Clinic: "What are NSAID allergies?"
Harvard Health Publishing: "FDA strengthens warning that NSAIDs increase heart attack and stroke risk." "NSAIDs: How dangerous are they for your heart?"
InformedHealth.org: "Using medication: The safe use of over-the-counter painkillers."
National Health Service: "NSAIDs."
U.S. Food and Drug Administration: "Nonsteroidal Anti-inflammatory Drugs (NSAIDs)."
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OTC Pain Relievers and Fever ReducersOver-the-counter pain medication and fever reducers include aspirin, acetaminophen and nonsteroidal antiinflammatory drugs (NSAIDs). Side effects, drug interactions, warnings and precautions, pregnancy and breastfeeding safety, and patient information should be reviewed prior to taking any medication.
Aspirin vs. NSAIDs (Side Effect and Use Differences)
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).
Corticosteroids vs. NSAIDs
Corticosteroids are synthetic hormones, and NSAIDs (nonsteroidal anti-inflammatory drugs) are non-narcotic pain relievers. Both medications reduce inflammation. NSAIDs are also used to treat pain and reduce fever.
flurbiprofen (Ansaid)flurbiprofen (Ansaid - discontinued brand) is a medication prescribed for the treatment of inflammation and pain caused by osteoarthritis, rheumatoid arthritis, soft tissue injuries like bursitis and tendinitis. Side effects, drug interactions, dosage, and pregnancy safety information should be reviewed prior to taking this medication.
Is Aspirin an Anti-Inflammatory?Aspirin is an anti-inflammatory drug that falls under a drug class called nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin is used to relieve pain and reduce inflammation and fever. In low doses, it can also be used as a preventative measure against heart attack and stroke.
Nonsteroidal Anti-inflammatory Drugs and UlcersNonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Nonsteroidal Antiinflammatory Drugs (NSAIDs)
Nonsteroidal antiinflammatory drugs (NSAIDs) are a class of drugs are used to treat inflammation, mild to moderate pain, and fever. Examples of the most common NSAIDs include: aspirin salsalate (Amigesic), diflunisal (Dolobid), ibuprofen (Motrin), ketoprofen (Orudis), nabumetone (Relafen), piroxicam (Feldene), naproxen (Aleve, Naprosyn,) diclofenac (Voltaren), indomethacin (Indocin), sulindac (Clinoril), tolmetin (Tolectin), etodolac (Lodine), ketorolac (Toradol), oxaprozin (Daypro), celecoxib (Celebrex).
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