A B C D E F G H I J K L M N O P R S T U V W

NSAID - ANTI INFLAMMATORY DRUGS

What are the types of NSAID?

Aspirin and other salicylates. Others include Ibuprofen, naproxen, fenbufen, fenoprofen, flurbiprofen, ketoprofen, tiaprofenic acid, azapropazone, diclofenac, dexketoprofen, meloxicam, diflunisal, etodolac, indomethacin, mefenamic acid, nabumetone, phenylbutazone, piroxicam, sulindac, tenoxicam and tolmetin. Some newer NSAID may be less likely to cause stomach irritation. These include celecoxib and rofecoxib.

What are NSAID's for ?

NSAIDs reduce both pain and inflammation. They are particularly useful if you have headaches, period pains, sprains and strains, or back pain. They are good for relieving the pain and swelling following minor injury. They also relieve pain and swelling of your joints if you have arthritis or any other rheumatic problem. However, they do not stop the progress of these diseases. Your doctor may prescribe other medications to tackle the underlying problem.

How do NSAID's work ?

If your body tissues get inflamed or damaged, they release chemicals called prostaglandins at the point of "injury". NSAIDs stop your tissues producing the prostaglandins and therefore reduce pain. They also lessen the swelling and inflammation produced by prostaglandins and other chemicals produced by tissue damage.

How should NSAID's be used ?

Usually NSAIDs come as tablets or capsules, but liquids, suppositories or creams are sometimes used. There are long-acting types, which are particularly useful for taking at night, to prevent morning stiffness. You might need to take your NSAID regularly if you have constant or regular pain, or just when you need it if your pain is occasional. If you are not sure ask your doctor or pharmacist (check the label first).

During Treatment with NSAID's

NSAIDs usually relieve pain within 1 to 2 hours. If you have arthritis or any other rheumatic disease, it may take 2 or 3 weeks of continuous treatment before they have their full anti-inflammatory effects. By this time you may find that the stiffness in your joints is reduced. Different NSAIDs work for different people. Your doctor may have to try a number of different NSAIDs before finding one that suits you best. They can cause mild nausea and indigestion. This can be eased by taking them with food or milk. Tell your doctor if the symptoms persist: NSAIDs can cause bleeding and ulcers in the stomach or duodenum. These problems can be prevented by acid-reducing drugs, often making it possible for the NSAIDs to be continued. However, some doctors may advise you to stop your NSAID if you are troubled by stomach symptoms. Allergic reactions to NSAIDs are rare. They are more likely if you have had other allergies in the past. A rash, wheezing or worsening of asthma may be an allergic reaction to NSAIDs: stop them and see your doctor immediately. NSAIDs can cause you to retain water. You may notice your ankles swelling. If you have a heart failure problem, it could be made worse by NSAIDs. In addition to the above, NSAIDs can cause ringing in the ears (tinnitus) and dizziness. Creams do not usually cause problems unless you use very large amounts: then you might get similar problems as with the tablets. If you get a rash, stop using your NSAID cream.

Drug Interference

You shouldn't take more than one NSAID at the same time because you are more likely to get side-effects. Blood thinners (anticoagulants) become more active. Your doctor may want to check your blood and lower the dose of the usual blood-thinning drug, warfarin, to reduce the risk of bleeding. There is a small risk of fits occurring in patients taking both Ciprofloxacin (an antibiotic) and an NSAID: your doctor will choose an alternative antibiotic. Diabetic tablets (except metformin) are made more active. This risks a low sugar (or hypo). Lithium (an antidepressant) becomes more active: its dose may need to be reduced. Steroids themselves increase the risk of stomach irritation, ulcers and gastric bleeding. Using them at the same time as NSAIDs can increase the risk of such problems. Some anticonvulsants may become more active when taken with certain NSAIDs: their dose may need to be reduced. NSAISs can increase the effect of methotrexate, and these drugs should only be used together if specifically recommended by your doctor. This is not a full list. Before starting NSAIDs discuss your other medication with your doctor. Despite the above comments, do not stop taking any medication or change any doses unless you have discussed it with your doctor.

What if NSAID's are not taken ?

If you take an NSAID regularly for arthritis or any rheumatic disorder and you stop it, your problems will come back. Speak to your doctor about it before stopping it. If you just take them when you are in pain, stopping them will mean your pain is not relieved, but you will soon find out whether you need to continue them!

General advice on NSAID's

NSAIDs can worsen kidney or liver problems and can trigger asthma. If asthma or other allergy has occurred with any other anti-inflammation drug like aspirin, NSAIDs could be dangerous. NSAIDs should not be used if you are pregnant unless discussed with your doctor first. Most are safe during breast-feeding. Aspirin should be avoided during breast-feeding, and should not be given to children under age 12: a very severe reaction causing liver and brain damage can occur. If you have any questions not dealt with in this leaflet, please ask your pharmacist or doctor. Keep this leaflet handy in case you need to refer to it at a later date.