NSAIDs Prescription

About NSAIDs (nonsteroidal anti-inflammatory drugs)

NSAIDs are medications designed to reduce inflammation. They’re often prescribed to help treat inflammatory conditions in the patient's body, but they’re used for other conditions as well. NSAIDs are also highly effective at treating certain pain symptoms that are linked to inflammatory triggers. There are six types of prescription NSAIDs.

What NSAIDs treat

The most common condition treated with NSAIDs is inflammation and pain. The drugs are designed to help pain symptoms in patients where opioids are not necessary due to a lower severity of pain symptoms. The drugs does not contain opioids or steroidal chemicals that some of the other pain relief medications sometimes use.

Other conditions are also treated with NSAIDs. A low dose aspirin is sometimes provided to patients who have risk factors for heart attacks and strokes. The low dose aspirin can help to reduce the blockage of arteries. Doctors also sometimes use NSAIDs to help in the management of arthritis symptoms. This is due to the fact that the NSAIDs block both pain and inflammation that occurs among those who have this condition. Women sometimes also turn to anti-inflammatory drugs NSAIDs to experience period pain relief.

There are both over-the-counter and prescription NSAIDs available. A doctor will assess the patient's condition and the risks that may be involved with taking NSAIDs. They can then decide whether a prescription NSAID might be a good option or, rather an over-the-counter option. In cases where the patient has too many risks, the healthcare provider may choose a different type of medicine to help relieve pain.

Types of NSAIDs available online

In cases of more severe pain, taking NSAIDs only available through a prescription tend to offer greater relief. We take a closer look at the NSAIDs that are currently available through online prescription services below.

Salicylates

Salicylates are most often used to treat pain ranging from mild to moderate severity. These drugs may also provide an effective reduction in fever among patients who are treated with them. The fever often accompanies other symptoms, such as inflammation and pain.

Salicylates, such as the commonly used aspirin, block prostaglandin production. Prostaglandins are chemicals the body naturally produces and releases in response to an injury or when inflammation occurs. They cause further swelling, which can also contribute to the pain symptoms the patient experiences.

Healthcare providers often prescribe salicylates to patients with headaches, toothaches, and muscle aches. Some women find that these medications help with their menstrual cramps too. In some cases, doctors also provide salicylates to people with arthritis.

Examples of salicylates include:

Aspirin

Tricosal (Choline salicylate or magnesium salicylate)

Acetic acid derivatives

Acetic acid derivatives are often used to help manage muscle cramps and other pain symptoms involving inflammation. Apart from muscle cramps, individuals may also use acetic acid derivatives to treat backaches, menstrual cramps, and dental pain. This medication is often provided to treat individuals who experience an injury during a sports event. The drug class has also shown potential in treating rheumatoid arthritis and osteoarthritis that only produces moderate or mild symptoms.

There are certain off-label uses for acetic acid derivatives. A powder that contains Diclofenac is a common remedy for people who experience headaches. Voltaren, a brand name for Diclofenac, has also been suggested as a potential treatment option for patients with ankylosing spondylitis:

Examples of acetic acid derivatives include:

Voltaren (Diclofenac)

Indomethacin

Ketorolac

Etodolac

Enolic acid (Oxicam) derivatives

Enolic acid derivatives are also common types of NSAIDs that may help to assist in reducing inflammatory triggers in the body. These drugs have some properties that are similar to the COX-2 selectivity drugs on the market, but they do not share the same classification. These drugs have a relatively high level of plasma protein binding, which contributes to the overall effectiveness that they offer.

Apart from treating generalized pain, enolic acid derivatives can also provide relief in patients with rheumatoid arthritis, juvenile idiopathic arthritis, and those with osteoarthritis.

Examples of enolic acid derivative NSAIDs include:

Mobic (Meloxicam)

Piroxicam

Tenoxicam

Ampiroxicam

Lornoxicam

Propionic acid derivatives

Propionic acid derivatives are a common type of NSAID that people use to treat both pain and inflammation symptoms. These medications work by inhibiting the functions of a specific enzyme known as cyclooxygenase, or COX. When the functions of this enzyme are inhibited, the body produces less prostaglandin. This is the chemical that is responsible for increasing swelling in areas of injury. Note that there are different types of cyclooxygenase enzymes in the body. Some propionic acid derivatives are able to inhibit the activity of both, whereas others may only work on one.

There are certain cases where this pain reliever is combined with other medications to provide more significant relief of the patient's symptoms. Higher doses of NSAIDs prescribed for patients may also help with more severe pain levels. Additionally, a doctor's prescription sometimes combines the use of propionic acid derivatives with an opioid. This can help to provide more significant relief of pain symptoms.

Examples of propionic acid derivative NSAIDs include:

Aleve (Naproxen)

Ibuprofen

Fenbufen

Suprofen

Fenoprofen

Benoxaprofen

Pirprofen

Indoprofen

Ketoprofen

Anthranilic acid derivatives (Fenamates)

Fenamates, which belong to the anthranilic acid derivatives class of NSAIDs, are effective against mild to moderate levels of pain symptoms. These medications were first introduced to the public in the 1960s and remain common options for the treatment of certain conditions.

Fenamates are often used to help in the management of pain after a surgical procedure. Back pain relief is also possible with the use of these medications. Some people find that these prescription medicines help with migraines, menstrual pain, and symptoms of rheumatoid arthritis too.

Examples of anthranilic acid derivatives include:

Ponstel (Mefenamic acid)

Selective COX-2 inhibitors (Coxibs)

Selective COX-2 inhibitors are specific medications that block the functionality of cycloxygenase-2 enzymes in the body. These enzymes are involved in the inflammatory responses of the human body. By blocking the enzymes, the selective COX-2 inhibitors are able to reduce further inflammation, which also contributes to their ability to relieve pain. These drugs are very common in rheumatology and often come in capsules that allow for a slow release of the active chemicals that are part of the drug.

There is one major benefit that Coxibs have over other types of NSAIDs. The structure of these NSAIDs focuses on reducing the impact that the medicine has on the gastrointestinal tract while still providing an effective pain reliever. The medication is less likely to cause an upset stomach, even at higher doses. This also means people have a reduced risk of stomach pain and stomach ulcers when they use selective COX-2 inhibitors.

Selective COX-2 inhibitors are often used to help with the management of migraines. This is not an OTC NSAID, and a doctor needs to determine the right dosage for every patient based on their condition and severity.

Examples of Selective COX-2 inhibitors include:

Celebrex (Celecoxib)

Etoricoxib

Valdecoxib

Rofecoxib

How NSAIDs work

NSAIDs (nonsteroidal anti-inflammatory drugs) function by reducing the production of certain enzymes in the body. The enzymes that they block are involved in the inflammatory responses that the body naturally experiences.

Side effects of NSAIDs

When taken as prescribed, NSAIDs are generally well tolerated. However, they can still cause some side effects. The side effects do depend on the type of NSAID that the patient uses. Certain types have an increased risk of serious side effects, whereas others are less dangerous, even as a long-term treatment option to reduce pain.

The more common side effects of NSAIDs include:

Irritation to the stomach lining can cause pain and discomfort
Heartburn and indigestion
Diarrhea or constipation
Nausea and vomiting

People who use NSAIDS frequently may find that they easily get bruised, even with small bumps. Some NSAIDs may also lead to stomach bleeding or make the person more likely to bleed if they cut themselves. This is especially the case with higher doses that the patient may obtain as a prescription drug.

In rare cases, NSAIDs may cause serious side effects. These can include:

Blood Pressure: NSAIDs can sometimes affect blood pressure levels. Some of these can result in high blood pressure. This is one of the known risk factors for cardiovascular disease. Patients who already struggle with high blood pressure should be wary of the potential adverse effects that certain NSAIDs may have. High blood pressure can cause an increased risk of heart attack and other potential problems.
Bleeding: Certain NSAIDs, such as aspirin, can also increase the risk of bleeding. This can sometimes lead to internal bleeding, especially with prolonged usage. If the patient takes blood thinners, then the risk of bleeding becomes even more severe.
Allergic Reactions: There are cases where people experience an allergic reaction when they take certain NSAIDs. NSAID allergic reactions may lead to difficulty breathing, rashes on the skin, and other dangerous complications.
Kidney Disease: People taking NSAIDs should ensure they understand how these pills affect their kidneys. NSAIDs can result in fluid retention, which affects the kidneys. People with existing kidney disease should ensure they look out for any signs that may signal a worsening of their condition.

NSAIDs risks

NSAIDs are generally safe, but there are some risks if you have other medical conditions or take certain medications.

Before you take a prescribed NSAID, be sure to tell your doctor if you have any of the following conditions or issues:

Existing cardiovascular disease.
Kidney problems.
Experienced an allergic reaction to NSAIDs previously.
Have a history of stomach ulcers.
If taking NSAIDs lead to other unpleasant side effects in the past.

NSAIDs drug interactions

When you begin a new medication, make sure to tell your doctor about any other medications, supplements, or herbs you’re taking. Some medications that might interact with an NSAID include:

Beta blockers, which may result in an antihypertensive action.
ACE inhibitors, which can impair renal function
Statin drugs, which can affect the metabolism of the NSAID
Corticosteroids, which may alter the efficacy of NSAID drugs
Anticoagulants, in which case there is an increased risk of bleeding

NSAIDs FAQs

How should I take NSAIDs?

It is generally a good idea to take NSAIDs with a full glass of water and food. This is due to the risk of stomach ulcers and other digestive side effects associated with these medications.

Who shouldn’t take NSAIDs?

If you have existing problems with your cardiovascular or kidney health, then it might not be a good idea to take NSAIDs. People who have had a heart attack in the past should also carefully weigh the risks that come with the use of NSAIDs.

How long does it take for NSAIDs to work?

Taking NSAIDs usually provides a short-term treatment solution. They do not take long to start working. Most people should find that the drug starts to provide improvements in their symptoms after a few hours. If you are taking NSAIDs over a period of time based on the doctor's prescription, then it may take up to two weeks before you notice improvements.

What should I avoid with NSAIDs?

Do not combine NSAIDs with other medications that may increase your risk of bleeding. You should also avoid drugs that may raise your blood pressure level while using anti-inflammatory drugs NSAIDs. It is also important to avoid using alcohol if you recently took one of these drugs.

Which drugs are NSAIDs?

There are several types of drugs that are classified as non-steroidal anti-inflammatory drugs. These include salicylates, acetic acid derivatives, enolic acid derivatives, propionic acid derivatives, fenamates, and coxibs.

Is Tylenol considered an NSAID?

Tylenol contains the main ingredient acetaminophen. This is not a type of non-steroidal anti-inflammatory drug. Thus, Tylenol cannot be classified as an NSAID. Instead, this medication is a type of analgesic used to treat pain in particular. It may also help to reduce fever.

What is the most powerful NSAID?

There are several NSAIDs that have potent effects on the body, which can be useful in cases where the patient experiences severe pain. The doctor will still need to assess the situation and consider the risks. They can then decide on a particular NSAID that will work best for the patient and provide a high dose if needed.

Is an NSAID the same as ibuprofen?

The term "NSAID" refers to a drug class that consists of medications that can help to reduce inflammatory triggers in the body. Ibuprofen is one of the drugs that falls within this particular class.

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Sources:

PlushCare is dedicated to providing you with accurate and trustworthy health information.

NSAIDs." American College of Rheumatology, 2023, https://www.rheumatology.org/i-am-a/patient-caregiver/treatments/nsaids. Accessed August 19, 2024.

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NSAIDs prescriptions available online