Nonsteroidal anti-inflammatory drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain and fever and to reduce swelling and inflammation caused by injury or diseases such as arthritis. Aspirin, ibuprofen, ketoprofen, and naproxen are commonly used NSAIDs.

NSAIDs may cause side effects. The most common are stomach upset, heartburn, and nausea. NSAIDs may irritate the stomach lining. If the medicine upsets your stomach, you can try taking it with food. But if that doesn't help, talk with your doctor to make sure it's not a more serious problem.

Frequent or long-term use of NSAIDs may lead to stomach ulcers or high blood pressure. They can also cause a severe allergic reaction.

NSAIDs have the potential to increase the risk of heart attack, stroke, skin reactions, and serious stomach and intestinal bleeding. These risks are greater if NSAIDs are taken at higher doses or for longer periods than recommended.

Aspirin, unlike other NSAIDs, can help certain people lower their risk of a heart attack or stroke. But taking aspirin isn't right for everyone, because it can cause serious bleeding. Talk to your doctor before you start taking aspirin every day.

Because aspirin can increase the risk of bleeding, it is not recommended for new injuries. Take other medicines such as ibuprofen or naproxen for the first 2 or 3 days after an injury.

NSAIDs should be taken exactly as prescribed or according to the label. Taking a larger dose or taking the medicine longer than recommended can increase the risk of dangerous side effects.

Talk to your doctor about whether NSAIDs are right for you. People who are older than 65 or who have existing heart, stomach, kidney, liver, or intestinal disease are at higher risk for problems. For other people, the benefits may outweigh the risks.

Aspirin should not be given to anyone younger than 20 because of the risk of Reye syndrome, a rare but serious disease.

How to take it

What are some cautions about nonsteroidal anti-inflammatory drugs (NSAIDs)?

Taking NSAIDs has some risks. These include increased risks of heart attack, stroke, skin reactions, and serious bleeding. People who are over 65 or have heart, stomach, kidney, liver, or intestinal disease have increased risks. Taking NSAIDS when you are also taking certain medicines may increase the risks.

What is the usual dose of ibuprofen for children?

For children, the dose of ibuprofen (such as Motrin or Advil) is based on the child's weight. Do not use ibuprofen if your child is less than 6 months old unless the doctor gave you instructions to use it. Be safe with medicines. For children 6 months and older, read and follow all instructions on the label.

Before you give medicine to reduce a fever in a baby who is 3 months of age or younger, talk to your doctor. You need to make sure that a young baby's fever isn't a sign of a serious illness.

Give follow-up doses every 6 hours as needed, up to a maximum of 4 doses in a 24-hour period.

What are some cautions about NSAIDs?

Cautions for NSAIDs include the following:

  • NSAIDs can make certain serious conditions more likely, such as:
    • Stomach problems, especially in older adults. These problems include stomach or intestinal bleeding.
    • Heart attack and stroke. This is especially true if you have heart disease or risk factors for heart disease. This risk may be higher if you use NSAIDs for a long time or use higher doses of an NSAID.
    • A sudden kidney problem called acute kidney injury.
  • NSAIDs can make certain health problems worse, such as heart failure and kidney disease.
  • If you are using over-the-counter NSAIDs, don't use them for longer than 10 days without talking to your doctor.

Why it's used

What do nonsteroidal anti-inflammatory drugs (NSAIDs) do?

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce fever and inflammation and relieve pain. Examples of NSAIDs include aspirin, ibuprofen, and naproxen.

When to call

Nonsteroidal anti-inflammatory drugs (NSAIDs): When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You vomit blood or what looks like coffee grounds.
  • You pass maroon or very bloody stools.

Call your doctor now or seek immediate medical care if:

  • Your stools are black and tarlike or have streaks of blood.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

What you should know

How can you safely use NSAIDs?

  • Do not use an over-the-counter NSAID for longer than 10 days. Talk to your doctor first.
  • The most common side effects from NSAIDs are stomachaches, heartburn, and nausea. NSAIDs may irritate the stomach lining. If the medicine upsets your stomach, you can try taking it with food. But if that doesn't help, talk with your doctor to make sure it's not a more serious problem, such as a stomach ulcer or bleeding in the stomach or intestines.
  • Using NSAIDs may:
    • Lead to high blood pressure.
    • Make symptoms of heart failure worse.
    • Raise the risk of heart attack, stroke, kidney damage, and skin reactions.
  • Your risks are greater if you take NSAIDs at higher doses or for longer than the label says. People who are older than 65 or who have heart, stomach, or intestinal disease have a higher risk for problems.

Aspirin

Aspirin is not like other NSAIDs. It can help people who are at high risk for heart attack or stroke. But taking aspirin isn't right for everyone, because it can cause serious bleeding.

Talk to your doctor before you start taking aspirin every day. You and your doctor can decide if aspirin is a good choice for you based on your risk of a heart attack or stroke and your risk of serious bleeding. Unless you have a high risk of a heart attack or stroke, the benefits of aspirin probably won't outweigh the risk of bleeding.

  • If you use other NSAIDs a lot, aspirin may not work as well to prevent heart attack and stroke.
  • If you take aspirin every day for your heart, talk with your doctor before you take other NSAIDs.
  • Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness.

Side effects

What are the side effects of NSAIDs?

The most common side effects of NSAIDs are stomach upset, heartburn, and nausea. NSAIDs can cause a severe allergic reaction. Symptoms may include hives, swelling of the face, wheezing, and shock. If you have any of these symptoms, call911. Taking more of the medicine than what's recommended can increase your risk of side effects.

Risks

What are some cautions about nonsteroidal anti-inflammatory drugs (NSAIDs)?

Taking NSAIDs has some risks. NSAIDs include aspirin, ibuprofen, and naproxen.

  • Taking NSAIDs may increase your risk of heart attack, stroke, skin reactions, and serious stomach bleeding. These risks are greater if you take NSAIDs at higher doses or for longer periods than recommended.
  • NSAIDs can make certain health problems worse, such as asthma and heart disease.
  • Aspirin can lower risks of heart problems. But it can also cause serious bleeding. Talk to your doctor before you start taking aspirin daily.

People who are older than 65 or who have heart, stomach, kidney, or liver disease are at higher risk for problems. Taking NSAIDs when you're also taking certain medicines may increase the risks.

If you are pregnant, trying to become pregnant, or breastfeeding, don't use NSAIDs unless your doctor says it's okay.


Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.

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