Introduction

Nonsteroidal Anti-inflammatory Drugs or NSAIDs (pronounced en-saids), are the most prescribed medications for treating conditions such as arthritis. Most people are familiar with over-the-counter, nonprescription NSAIDs, such as aspirin and ibuprofen.

NSAIDs are more than just pain relievers. They also help reduce inflammation and lower fevers. They prevent blood from clotting, which is good in some cases but not so beneficial in others.

For example, because they reduce clotting action, some NSAIDS, especially aspirin, may have a protective effect against heart disease. However, you may bruise more easily. NSAIDs can increase the risk of developing nausea, an upset stomach, or an ulcer. They also may interfere with kidney function.

Most common types of NSAIDs

There are many types of non-prescription (over-the-counter) and prescription NSAIDs. The four NSAIDs most often used to treat back and neck pain are:

Aspirin (Bayer, Bufferin, and Ecotrin, St. Joseph): In addition to treating pain, fever, and inflammation, Aspirin may also reduce the risk of a heart attack. It is available over the counter and sometimes by prescription.

Ibuprofen (Advil, Motrin): Ibuprofen can treat a range of conditions including post-surgical pain and pain from inflammatory diseases, such as ankylosing spondylitis. It is available over-the-counter and by prescription.

Naproxen (Aleve, Anaprox DS, Naprosyn): Naproxen is commonly used to treat back pain, strained muscles, and low back pain. It is available over-the-counter and by prescription.

Celecoxib (Celebrex): Celecoxib is most often used to treat pain caused by different forms of arthritis, including spinal osteoarthritis and rheumatoid arthritis. It is available by prescription.

What are nonsteroidal anti-inflammatory agents used for?

NSAIDs are used to treat mild-to-moderate pain that arises from a wide range of conditions such as headaches, menstruation, migraines, osteoarthritis or rheumatoid arthritis, sprains and strains, and toothache.

Aspirin is a NSAID that is used in small doses to lower the risks of having a heart attack or a stroke caused by a blood clot. It may also be given as a single dose at the time of a heart attack to improve outcomes. This is because it irreversibly inhibits the COX-1 enzyme.

Side effects

NSAIDs can potentially cause a range of side effects, especially when used at higher than recommended dosages for long periods of time. Gastrointestinal side effects that may occur include bloating, diarrhea, and constipation, irritation of the lining of the stomach, nausea or vomiting.

NSAIDs may also affect kidney function and reduce how quickly blood flows through the kidneys. They may cause retention of sodium and water which can lead to edema and high potassium levels. Occasionally, they may cause more serious damage to the kidneys.

Some NSAIDs, particularly diclofenac and those that are selective for COX-2 enzymes, have a high risk of cardiovascular thrombotic events such as a heart attack or stroke. Other heart-related side effects such as high blood pressure, congestive heart failure, and palpitations have also been reported.

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Regards

Mary Wilson

Editorial office

Clinical Pharmacology and Toxicology Research

E-mail: pharmatoxicol@eclinicalsci.com