Non-steroidal anti-inflammatory drugs (NSAIDs)

What are NSAIDs?

Non-steroidal anti-inflammatory drugs (commonly known as NSAIDs) are widely used and effective in the treatment of arthritis and many other painful conditions. There are many medicines in the NSAID class. Most, like diclofenac (Voltarol) and naproxen (Naprosyn) are only available on prescription, whilst ibuprofen (Nurofen) can also be bought in shops and pharmacies.

How do NSAIDs work?

If you have a sprain or strain, or an inflammatory disease such as arthritis, your body releases chemicals called prostaglandins, which travel rapidly to the injured area. Prostaglandins make the tissue around the injury swell up and become inflamed, causing you to feel pain. NSAIDs prevent the production of prostaglandins, stopping further swelling and relieving pain.

NSAIDs are useful painkillers for most forms of cancer pain.

What is known about the safety of NSAIDs?

Most people who take NSAIDs do not experience any major side-effects. However, you should always read the leaflet that comes with the tablets, as it will list all the cautions and possible side-effects.

Side effects

The most commonly reported side effect of long term use of NSAIDs is stomach irritation. If taken over long periods of time, NSAIDs can irritate your stomach lining and may cause it to bleed. Sometimes, this can lead to an ulcer developing. If you have to take NSAIDs for a persistent or recurring problem, your doctor may also prescribe anti-ulcer medication to prevent ulcers.

If you are taking NSAIDs and you develop upper abdominal pains, pass blood or black stools, or vomit blood, you should stop taking the medication immediately. Also, you should see your doctor as soon as possible or go to the nearest casualty department.

NSAIDs can worsen the effects of kidney disorders, so are not advised for people with this condition.

NSAIDs can cause additional complications for patients with existing heart conditions. Seek advice from your GP if NSAIDs are prescribed.

In rare cases, NSAIDs may cause an allergic reaction, usually resulting in a painless skin rash. If you develop an allergic reaction, take advice from your chemist or visit your doctor as soon as possible. You can also call NHS Direct on 0845 4647 for immediate advice.

How often do I take NSAIDs?

The dose will depend on the type of NSAID being used, what form it takes (tablet, capsule, liquid, cream, spray or suppositories) and what condition it is being used for. Unless otherwise directed by the doctor, you should always follow the instructions provided or as stated on the packaging.

Do not use more than one NSAID treatment at the same time.

What should patients do if they are concerned?

Anyone who is concerned about their medicine should discuss the matter with their pharmacist or doctor at a routine appointment.

References

NHS Direct
Patient Information Leaflet - Anti-inflammatories, non-steroidal
http://cks.library.nhs.uk
August 2007

St Barnabas House
Non-steroidal Anti-inflammatory Drugs (NSAIDs) Guidelines
August 2006