What are Non-Steroidal Anti-Inflammatory Medications?
Non-Steroidal Anti-Inflammatory medications are a type of drug used to reduce inflammation. They are widely available and commonly used.
NSAIDs can be used to help people with conditions causing ongoing pain, such as arthritis, or with acute injury. Some common NSAIDs include aspirin, ibuprofen (Nurofen), naproxen (Naprosyn), diclofenac (Voltaren) and celecoxib (Celebrex).
NSAIDs are an effective way of relieving pain, but can also cause problems of their own. It is important to only take them for a small amount of time.
Are NSAIDs safe for everyone?
No, there are certain people who cannot take NSAIDs, or need to use them with care. It is important to discuss with your doctor if you use NSAIDs without a prescription to ensure they are safe for you, especially if you:
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Have a stomach ulcer or have ever had bleeding from your gut, as NSAIDs can cause or worsen these conditions
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Have heart disease or have had a stroke, or have high blood pressure, as NSAIDs can affect the risk of heart attack or stroke
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Have kidney disease, heart failure, liver cirrhosis or you take medications called diuretics (‘fluid tablets’). If you have these, you should avoid taking NSAIDs completely.
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Have high blood pressure. If you have high blood pressure or take blood pressure medications, you should discuss using NSAIDs with your doctor before you commence taking them.
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Have any disorders that increase the risk of bleeding
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Having surgery (most people need to stop NSAIDs prior to surgery)
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Are pregnant
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Taking any other prescription or non-prescription medications or herbal remedies. This is especially important if you take Warfarin (a blood thinner), Phenytoin (a medication used to prevent seizures) or cyclosporine (a medication used in people after an organ transplant). These medications can interact with NSAIDs so it is important to discuss this with your doctor prior to starting any non-prescription NSAID.
What are the side effects?
While NSAIDs are effective in relieving pain and inflammation, they can cause unwanted side effects such as:
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Stomach upset (including nausea)
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Stomach pain
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Ulcers and bleeding in the stomach or other parts of the gastrointestinal tract
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Raised liver enzymes (detected by a blood test)
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Salt and fluid retention
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High blood pressure
Other less common side effects include:
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Ulcers of the oesophagus (food pipe)
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Rectal irritation (if suppositories are used)
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Heart failure
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High levels of potassium in the blood (hyperkalaemia)
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Reduced kidney function
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Difficulty breathing (bronchospasm)
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Skin rash
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Skin irritation, reddening or itching (if skin products are used, such as gel)
NSAIDs, with the exception of low dose aspirin, can increase the risk of heart attack and stroke, even in healthy people.
How can I use them safely?
In general, using NSAIDs occasionally rather than every day, and at the lowest dose possible reduces the chance of serious side effects. If you have any of the risk factors mentioned above, or are concerned about any of the side effects of NSAIDs, please discuss this with your GP. IF you need to take NSAIDs for a longer period of time, it is important to discuss this with your GP to ensure that it is the correct treatment option for you, and to help you reduce your risks of side effects during this time.
It is also important to know that some over the counter medications, such as cold and flu tablets, contain NSAIDs. If you take these in combination with another NSAID, it can increase your risk of side effects. If you are unsure about the ingredients of your over the counter medications, and whether they are safe, please discuss this with your pharmacist or GP.
If you experience any of the following, stop taking your NSAID immediately and seek medical attention:
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Difficulty breathing
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Black stools
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Dark, coffee ground coloured vomit
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Swollen ankles
If you, or anyone you know takes too much of an NSAID at once, please seek medical attention and call the Poisons Hotline for advice if required (13 11 26).
If you are interested in learning more about this topic, feel free to book an appointment with one of our friendly doctors by booking online or contacting us by phone on 8269 6000.
References
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Better Health Channel 2017, Medications – non-steroidal anti-inflammatory drugs, Better Health Channel Victoria, retrieved online 9/9/17, retrieved from < https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs >
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Crowley K, Martin KA 2017, Patient Education: Nonsteroidal anti-inflammatory drugs (NSAIDs) (The Basics), UpToDate, retrieved online 9/9/17, retrieved from < https://www-uptodate-com.proxy.library.adelaide.edu.au/contents/nonsteroidal-antiinflammatory-drugs-nsaids-the-basics?source=search_result&search=basic%20over%20the%20counter&selectedTitle=3~150#H1726698 >
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