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Non-steroidal anti-inflammatory drugs (NSAIDs)This factsheet is for people who would like information about taking non-steroidal anti-inflammatory drugs (NSAIDs). Nonsteroidal anti-inflammatory drugs, more commonly called NSAIDs (pronounced "en-sayds"), relieve pain, reduce inflammation and lower a high temperature. Examples of NSAIDs include ibuprofen and asprin.
Why would I take them?You might take NSAIDs to relieve mild to moderate pain caused by:
NSAIDs also lower a fever if you have a cold or flu. And, because they also reduce inflammation, many people take NSAIDs for osteoarthritis and other joint diseases. How do NSAIDs work?NSAIDs work by blocking the production of chemicals in the body known as prostaglandins. These chemicals are part of the body's defences, and are involved in sending pain signals to your brain when there is inflammation and tissue damage. NSAIDs also block another chemical in your body that helps to make prostaglandins. This is an enzyme known called cyclo-oxygenase, or COX. So NSAIDs are also "COX inhibitors". How to take NSAIDsYou can buy oral ibuprofen (eg Advil, Cuprofen, Ibuleve, Nurofen and many own-brands) without a prescription from pharmacies, and from other shops, in packs of 12 tablets. NSAIDs are usually taken by mouth (orally) as tablets, capsules or liquid. In hospital they come as injections and suppositories. You should take oral NSAIDs with or after food or milk, as this can help to minimise the stomach side-effects. You shouldn't exceed the dose recommended on the packet. For adults this is 400mg (usually two tablets), every eight hours. Many cold and flu remedies also contain ibuprofen, sometimes in combination with other medicines such as the cough-suppressant codeine or a decongestant. NSAIDs also come as creams and gels that you rub into your skin for joint or muscle pain. You can rub these gently into the painful area three or four times a day for up to a week to relieve pain. You shouldn't apply them to broken or infected skin, near your eyes or mouth, under plasters or dressings, or in the same place as other skin creams or lotions. Most other NSAIDs are only available on prescription from your doctor. There are many different NSAID medicines and not all of them work equally well for everybody. You may need to try several types to find one that suits you best. NSAIDs for childrenA liquid form of ibuprofen, containing 100mg of the medicine per 5ml, (for example, Nurofen for Children) can be given to children over six months old, and to younger babies on the advice of a doctor. Most other NSAIDs should not be given to children under 12. Ask your pharmacist for advice. Always read the patient information leaflet that comes with your medicine. Special careAsk your pharmacist before taking an oral NSAID if you:
You shouldn't take NSAIDs if you:
Side-effectsYou are unlikely to get side-effects from taking ibuprofen occasionally for pain relief. If you have to take the prescription-only NSAIDs regularly, you may get some of the following side-effects, especially if you are over 65. These include:
Other, less common, side-effects of NSAIDs include:
NSAIDs can also cause allergic reactions such as skin rashes and wheezing, especially in people who get asthma. NSAIDs in the form of creams and gels can cause reddening, smarting, itching and skin rashes when rubbed on the skin. Tell your doctor or pharmacist if you develop any of these, or other side-effects. You should contact your doctor immediately if you have:
These are signs of bleeding from the stomach or intestines. Interactions with other medicinesCheck with your doctor or pharmacist before you take any other medicines or herbal remedies at the same time as an NSAID. Some NSAIDs can increase the blood-thinning effects of a drug called warfarin, which is used for treating heart problems and blood clots in the veins. Names of common NSAIDsExamples of common NSAIDs are shown in the table. The generic name is the chemical name of a medicine. If a manufacturer has rights over a medicinal compound, it is given a brand name. Often there is more than one brand name associated with a generic name. Generic names are normally written with a lower-case initial letter and brand names normally start with an upper-case letter.
Further information
Sources
Published by BUPA's health information team, healthinfo@bupa.com, February 2007.
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