What Are NSAIDs?

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain and inflammation and are often used in the treatment of psoriatic arthritis (PsA), particularly in mild cases.1 NSAIDs are available in over-the-counter and prescription formulations. Common NSAIDs include:

  • Aspirin
  • Ibuprofen (brand names include Motrin® and Advil®)
  • Naproxen (brand names include Aleve® and Naprosyn®)
  • Celebrex® (celecoxib)2

Uses of NSAIDs

NSAIDs are used to relieve pain and reduce signs of inflammation, including fever, swelling, and redness. NSAIDs are commonly used for temporary conditions, such as sprains, strains, flares of back pain, headache, and painful menstrual periods. NSAIDs are also commonly used to treat chronic conditions, including arthritis and lupus. While over-the-counter NSAIDs are often enough for temporary conditions like sprains or headache, doctors will often prescribe higher doses for chronic health conditions like psoriatic arthritis. Low doses of NSAIDs reduce pain, but higher doses are often needed to reduce inflammation.1

How NSAIDs work

NSAIDs block enzymes in the body that make prostaglandins, naturally occurring fatty acids that play a role in the inflammatory and pain processes. By blocking these enzymes, NSAIDs decrease inflammation, pain, and fever. Some NSAIDs, like ibuprofen, block two of these enzymes, COX-1 and COX-2. Celebrex, a prescription NSAID, targets COX-2 and is also known as a COX-2 inhibitor. Different NSAIDs may have similar effectiveness, but some people respond better to one NSAID than another.1,2

NSAIDs start to work quickly on pain, within a few hours of taking the medicine. The anti-inflammatory effects of NSAIDs take longer to realize.1

Possible side effects

Like all medicines, NSAIDs can cause unwanted side effects. Possible side effects of NSAIDs are stomach ulcers, stomach upset, high blood pressure, fluid retention (causing swelling around the lower legs, feet, ankles, and hands), kidney problems, heart problems, and rashes. Long-term use of NSAIDs has been associated with heart attacks and strokes. Although side effects can occur at any time, the risk of side effects increases with higher dosages and with a longer duration of treatment. Patients should discuss the risks and benefits with their doctor, as well as any additional precautions to avoid side effects.1,2

Although NSAIDs are very effective for relieving pain and inflammation, they are not the best choice for all people.1

Other precautions

People who have heart disease should not take an NSAID, including over-the-counter NSAIDs, without first talking to their doctor. Some NSAIDs may interfere with medicines prescribed to patients with heart disease.1

NSAIDs should not be used during pregnancy unless prescribed by a doctor. Women who are planning to become pregnant or breastfeeding should also talk to their doctor before taking NSAIDs.1

Patients with the following conditions should talk to their doctor before using NSAIDs: decreased kidney or liver function, hepatitis, ulcer, gastritis, low platelet count, Crohn’s disease, ulcerative colitis, asthma or other chronic lung disease, reflux disease, indigestion, hiatal hernia, high blood pressure, congestive heart failure, past stroke or heart attack, allergies to NSAIDs, use of blood thinners, use of corticosteroids, are 65 years of age or older, or alcohol consumption of more than seven alcoholic drinks per week or more than two a day.1

Written by: Emily Downward | Last reviewed: April 2018.
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