Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage the pain and inflammation (swelling and redness) associated with some types of arthritis (such as rheumatoid arthritis) and other musculoskeletal disorders. Show NSAIDs are also used to treat non-inflammatory conditions such as migraine, period pain and postoperative pain, and to reduce fever. is an NSAID with ‘blood-thinning’ properties. It can be used in low doses to reduce the risk of heart attack and stroke in high-risk patients. Some commonly used NSAIDs include:
How NSAIDs workProstaglandins are hormone-like chemicals in the body that contribute to inflammation, pain and fever by raising temperature and dilating blood vessels, which causes redness and swelling in the place they are released. NSAIDs block a specific enzyme called cyclooxygenase (or COX) used by the body to make prostaglandins. By reducing production of prostaglandins, NSAIDs help relieve the discomfort of fever and reduce inflammation and the associated pain. While NSAIDs are effective in relieving pain, fever and inflammation, they can cause unwanted side effects. Gastrointestinal side effects such as indigestion, stomach upset (including nausea or feeling sick) or stomach pain are commonly caused by NSAIDs. Use of NSAIDs can also cause ulcers and bleeding in the stomach and other parts of the gastrointestinal tract (gut). Other common side effects of NSAIDs include: Less common side effects include:
NSAIDs (with the exception of low-dose aspirin) may also increase the risk of heart attack and stroke, even in healthy people. In general, using NSAIDs occasionally rather than every day, and at the lowest dose possible, reduces your chances of developing serious side effects. If you’re concerned or unsure about your risk of side effects with NSAIDs, talk to your doctor or pharmacist. Take paracetamol for mild to moderate pain and fever before a NSAID as it has fewer adverse effects, unless you have been advised otherwise by your health professional. A topical NSAID (cream, gel or ointment) may provide enough relief from muscle and joint pain and inflammation, or relieve discomfort caused by strains or sprains. If a topical NSAID does not provide you relief from this kind of pain in the first instance, consider taking an oral NSAID. NSAIDs can provide reliefWhile NSAIDs can potentially cause many side effects – some of which may be serious or life-threatening – if prescribed under the right conditions and used as instructed, they can be of great benefit. Your doctor can help you consider the benefits and risks of taking an NSAID to ensure they’re the right treatment option for you. When you’re taking an NSAID, always use it cautiously, for the shortest time possible and at the lowest effective dose. If you need to use these medicines for a long time (for example, to manage the symptoms of arthritis when other therapies don’t offer relief, or when you’re taking low-dose aspirin to prevent a heart attack or stroke), make sure you see your doctor regularly. Do not take NSAIDs if you are dehydrated as you may be more likely to experience side effects. NSAIDs high-risk groupsSome people are at higher risk of developing serious complications from taking NSAIDs. Risk factors include:
Tell your doctor or pharmacist if you have any of the risk factors above before buying or taking an NSAID. They can advise whether an NSAID is suitable for you and discuss your risk of side effects. Do not take NSAIDs if you are:
Talk to your doctor if you’re unsure whether you should avoid taking NSAIDs. Drug interactions with NSAIDsNSAIDs may interact with other medicines to cause unwanted effects. For example:
Alcohol can irritate the stomach lining. Regular or heavy drinking of alcohol while taking NSAIDs may increase the risk of gastrointestinal damage or bleeding. If you are taking another medicine, check with your health professional before taking a NSAID in case you might be at risk of unwanted effects. Over-the-counter medicines can contain NSAIDsSome over-the-counter medicines contain NSAIDs, for example, pain relief medicines and some cough, cold and flu medicines. If you already take an NSAID, you may increase your risk of side effects or an accidental overdose if you also take an over-the-counter medicine that contains aspirin or another NSAID. Always check the active ingredient before buying any over-the-counter medicine and ask your doctor or pharmacist if you’re unsure whether it’s safe for you to take. Do not take more than one medicine containing an NSAID at the same time, unless your doctor recommends it. If you’re taking low-dose aspirin to reduce the risk of heart attack and stroke, you still need to consider the use of another NSAID carefully with your doctor. If you are taking any over-the-counter NSAIDs, tell your doctor or pharmacist, particularly if you are due to undergo surgery or are starting a new medicine. General suggestions for taking NSAIDsDo not take your NSAID for longer than your doctor recommends. Stop taking your NSAID and seek advice from your doctor immediately if you develop:
Other general suggestions when taking or planning to take NSAIDs include:
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