How NSAIDs Are Prescribed for Pain Relief

What are NSAIDs?

Non-steroidal anti-inflammatory drugs (NSAIDs) are available in over-the-counter and prescription strength. NSAIDs belong to the drug class used as an analgesic (pain reliever), anti-inflammatory, and antipyretic (fever reducer). The most common over-the-counter NSAIDs include ibuprofen, naproxen, ketoprofen, and high-dose aspirin. Prescription strength NSAIDs include nabumetone, etodolac, naproxen, diclofenac, etc.

NSAIDs are proven to have fewer side effects compared to corticosteroids, which are also anti-inflammatory drugs. They should not be taken longer than recommended as serious side effects can occur.

How are NSAIDs prescribed?

Health care professionals prescribe the type of NSAID and dose according to the condition being treated. It may be prescribed to be taken once daily or up to four times per day. They work by blocking certain body chemicals that cause inflammation. NSAIDs are typically prescribed in higher doses if used to treat significant inflammation and swelling, such as that which may occur due to rheumatic diseases. Additionally, they are often prescribed to treat moderately painful musculoskeletal conditions.

Commonly prescribed NSAIDs include the following:

• Celecoxib
• Diclofenac
• Fenoprofen
• Indomethacin
• Ketorolac tromethamine
• Naproxen
• Nabumetone

A medical professional will weigh the risks and benefits of NSAIDs before prescribing them. A medical history will be evaluated, a physical exam performed, and additional tests ordered, such as X-rays and blood tests. The presence of other medical conditions contribute to the decision of prescribing NSAIDs. A health care professional will regularly check for harmful side effects after starting NSAIDs. This may include blood tests and kidney function testing.

Warnings

Prescription NSAIDs normally have a warning that they may increase the chance of a heart attack, stroke, and stomach bleeding. People experiencing certain conditions should avoid NSAIDs as much as possible. These conditions include, but are not limited to, the following:

• Individuals that have experienced severe side effects after taking a fever reducer or pain reliever.
• People with a high risk of stomach bleeding.
• Those with stomach problems and heartburn.
• Patients with heart disease, kidney disease, high blood pressure, or liver cirrhosis.
• Asthma patients.
• Individuals who take diuretic medicines.

Serious stomach issues and bowel side effects, such as ulcers and bleeding, can occur due to NSAIDs. They may occur without warning signs. This risk may be greater in those who fall into certain categories, which include the following:

• Older adults
• Previous history of bleeding problems or stomach issues
• Currently taking blood thinners
• Taking multiple prescriptions or over-the-counter NSAIDs
• Consume three or more alcoholic beverages per day

Seek immediate medical attention in cases of serious adverse effects, which include, but are not limited to, the following:

• Allergic reaction
• Ringing in the ears
• Fluid retention
• Black or tarry stool
• Severe stomach pain
• Blurred vision
• Blood in the urine or stool
• Rash, hives or itching
• Vomiting blood
• Chest pain
• Jaundice (yellowing of the eyes and skin)
• Rapid heartbeat