Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Reviewed by: HU Medical Review Board | Last reviewed: March 2023

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a large class of drugs used to relieve pain. They are used to relieve pain caused by many conditions. This includes endometriosis, psoriatic arthritis, rheumatoid arthritis, migraine, and menstrual pain. NSAIDs are also used as a first-line treatment for general pain, headaches, inflammation, and fevers.

Some NSAIDs are available over-the-counter (OTC). This includes aspirin, ibuprofen (Motrin, Advil), and naproxen (Aleve). Other NSAIDs, as well as higher dosages of OTC NSAIDs, may be available by prescription only.

What are ingredients in NSAIDs?

The active ingredient can vary depending on the specific NSAID you are taking. Common active ingredients include:1,2

  • Acetylsalicylic acid (aspirin)
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve)
  • Celecoxib (Celebrex)

The active ingredient of an NSAID can be found on the bottle of OTC medicines or in the prescribing information for prescribed NSAIDs. Your doctor or pharmacist can also tell you what the active ingredient in your NSAID is.

How do NSAIDs work?

In order to relieve pain, NSAIDs block several enzymes that are involved in the production of prostaglandins. Prostaglandins play a role in the inflammatory and pain response pathways in the body. By reducing or blocking the formation of prostaglandin, NSAIDs are able to reduce inflammation and pain.1,2

Enzymes are proteins that help carry out necessary bodily functions. The main enzymes that NSAIDs inhibit are cyclooxygenase (COX) enzymes. These can be further broken down into COX-1 and COX-2 categories. Non-specific NSAIDs, like ibuprofen or naproxen, block both of these.1,2

Newer NSAIDs, called COX-2 inhibitors, only block COX-2 enzymes. Doctors think this helps prevent some of the gastrointestinal symptoms that can come with other NSAIDs. The only COX-2 inhibitor on the market right now is Celebrex. COX-2 inhibitors should not be taken with other NSAIDs.1,2

What are the possible side effects of NSAIDs?

The most common side effects of NSAIDs include:3

Rare but serious side effects of NSAIDs include:3

  • Kidney problems
  • Anemia (low red blood cell count)
  • Liver problems
  • Skin reactions or increased sun sensitivity
  • Allergic reactions

These are not all the possible side effects of NSAIDs. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with NSAIDs.

Things to know about NSAIDs

NSAIDs can increase the risk of heart attack, stroke, and gastrointestinal bleeding. The risk of these complications increases with:1-3

  • Age
  • Long-term use
  • History of smoking
  • Alcohol use
  • Other medical conditions, including past heart-related issues
  • Using these drugs with other NSAIDs, steroids, or anti-coagulant drugs

If you experience any side effects that may be life-threatening, contact 9-1-1 right away.

Before beginning treatment for endometriosis, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

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