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Nonsteroidal anti-inflammatory drugs
Complete list of drugs used to
treat arthritis.
Nonsteroidal anti-inflammatory drugs are medicines that relieve pain, swelling,
stiffness, and inflammation.
Purpose of Nonsteroidal anti-inflammatory drugs / NSAIDS
Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed for a variety of painful
conditions, including arthritis, bursitis, tendonitis, gout, menstrual cramps, sprains,
strains, and other injuries.
Description of Nonsteroidal anti-inflammatory drugs / NSAIDS
Nonsteroidal anti-inflammatory drugs relieve pain, stiffness, swelling, and
inflammation, but they do not cure the diseases or injuries responsible for these
problems. Two drugs in this category, ibuprofen and naproxen, also reduce fever. Some
nonsteroidal anti-inflammatory drugs can be bought over the counter; others are available
only with a prescription from a physician or dentist.
Among the drugs in this group are diclofenac (Voltaren), etodolac (Lodine),
flurbiprofen (Ansaid), ibuprofen (Motrin, Advil, Rufen), ketorolac (Toradol), nabumetone
(Relafen), naproxen (Naprosyn); naproxen sodium (Aleve, Anaprox, Naprelan); and oxaprozin
(Daypro). They are sold as tablets, capsules, caplets, liquids, and rectal suppositories
and some are available in chewable, extended-release, or delayed-release forms.
Recommended dosage of Nonsteroidal anti-inflammatory drugs / NSAIDS
Recommended doses vary, depending on the patient, the type of nonsteroidal
anti-inflammatory drug prescribed, the condition for which the drug is prescribed, and the
form in which it is used. Always take nonsteroidal anti-inflammatory drugs exactly as
directed. If using non-prescription (over-the-counter) types, follow the directions on the
package label. For prescription types, check with the physician who prescribed the
medicine or the pharmacist who filled the prescription. Never take larger or more frequent
doses, and do not take the drug for longer than directed. Patients who take nonsteroidal
anti-inflammatory drugs for severe arthritis must take them regularly over a long time.
Several weeks may be needed to feel the results, so it is important to keep taking the
medicine, even if it does not seem to be working at first.
When taking nonsteroidal anti-inflammatory drugs in tablet, capsule, or caplet form,
always take them with a full, 8-ounce glass of water or milk. Taking these drugs with food
or an antacid will help prevent stomach irritation.
Precautions for Nonsteroidal anti-inflammatory drugs / NSAIDS
Nonsteroidal anti-inflammatory drugs can cause a number of side effects, some of which
may be very serious (See Side effects). These side effects are more likely when the drugs
are taken in large doses or for a long time or when two or more nonsteroidal
anti-inflammatory drugs are taken together. Health care professionals can help patients
weigh the risks of benefits of taking these medicines for long periods.
Do not take acetaminophen, aspirin, or other salicylates along with other nonsteroidal
anti-inflammatory drugs for more than a few days unless directed to do so by a physician.
Do not take ketorolac (Toradol) while taking other nonsteroidal anti-inflammatory drugs
unless directed to do so by a physician.
Because older people are more sensitive than younger adults to nonsteroidal
anti-inflammatory drugs, they may be more likely to have side effects. Some side effects,
such as stomach problems, may also be more serious in older people.
Serious side effects are especially likely with one nonsteroidal anti-inflammatory
drug, phenylbutazone. Patients age 40 and over are especially at risk of side effects from
this drug, and the likelihood of serious side effects increases with age. Because of these
potential problems, it is especially important to check with a physician before taking
this medicine. Never take it for anything other than the condition for which it was
prescribed, and never share it -- or any other prescription drug -- with another person.
Some nonsteroidal anti-inflammatory drugs can increase the chance of bleeding after
surgery (including dental surgery), so anyone who is taking the drugs should alert the
physician or dentist before surgery. Avoiding the medicine or switching to another type in
the days prior to surgery may be necessary.
Some people feel drowsy, dizzy, confused, lightheaded, or less alert when using these
drugs. Blurred vision or other vision problems also are possible side effects. For these
reasons, anyone who takes these drugs should not drive, use machines or do anything else
that might be dangerous until they have found out how the drugs affect them.
Nonsteroidal anti-inflammatory drugs make some people more sensitive to sunlight. Even
brief exposure to sunlight can cause severe sunburn, rashes, redness, itching, blisters,
or discoloration. Vision changes also may occur. To reduce the chance of these problems,
avoid direct sunlight, especially from mid-morning to mid-afternoon; wear protective
clothing, a hat, and sunglasses; and use a sunscreen with a skin protection factor (SPF)
rating of at least 15. Do not use sunlamps, tanning booths or tanning beds while taking
these drugs.
Special conditions concerning Nonsteroidal anti-inflammatory drugs / NSAIDS
People with certain medical conditions and people who are taking some other medicines
can have problems if they take nonsteroidal anti-inflammatory drugs. Before taking these
drugs, be sure to let the physician know about any of these conditions:
Allergies
Let the physician know about any allergies to foods, dyes, preservatives, or other
substances. Anyone who has had reactions to nonsteroidal anti-inflammatory drugs in the
past should also check with a physician before taking them again.
Pregnancy
Women who are pregnant or who plan to become pregnant should check with their
physicians before taking these medicines. Whether nonsteroidal anti-inflammatory drugs
cause birth defects in people is unknown, but some do cause birth defects in laboratory
animals. If taken late in pregnancy, these drugs may prolong pregnancy, lengthen labor
time, cause problems during delivery, or affect the heart or blood flow of the fetus.
Other medical conditions
A number of medical conditions may influence the effects of nonsteroidal
anti-inflammatory drugs. Anyone who has any of the conditions listed below should tell his
or her physician about the condition before taking nonsteroidal anti-inflammatory drugs.
People who have sores or white spots in the mouth should tell the physician about them
before starting to take nonsteroidal anti-inflammatory drugs. Sores or white spots that
appear while taking the drug can be a sign of serious side effects.
- Stomach or intestinal problems, such as colitis or Crohn's disease
- Liver disease
- Current or past kidney disease; current or past kidney stones
- Heart disease
- High blood pressure
- Blood disorders, such as anemia, low platelet count, low white blood cell count
- Bleeding problems
- Diabetes mellitus
- Hemorrhoids, rectal bleeding, or rectal irritation
- Asthma
- Parkinson's disease
- Epilepsy
- Systemic lupus erythematosus
- Diseases of the blood vessels, such as polymyalgia rheumatica and temporal arthritis
- Fluid retention
- Alcohol abuse
- Mental illness.
Special diets
Some nonsteroidal anti-inflammatory drugs contain sugar or sodium, so anyone on a
low-sugar or low-sodium diet should be sure to tell his or her physician.
Smoking
People who smoke cigarettes may be more likely to have unwanted side effects from this
medicine.
Use of certain medicines
Taking nonsteroidal anti-inflammatory drugs with certain other drugs may affect the way
the drugs work or increase the risk of unwanted side effects. (See Interactions.)
Side effects of Nonsteroidal anti-inflammatory drugs / NSAIDS
The most common side effects are stomach pain or cramps, nausea, vomiting, indigestion,
diarrhea, heartburn, headache, dizziness or lightheadedness, and drowsiness. As the
patient's body adjusts to the medicine, these symptoms usually disappear. If they do not,
check with the physician who prescribed the medicine.
Serious side effects are rare, but do sometimes occur. If any of the following side
effects occur, stop taking the medicine and get emergency medical care immediately:
- Swelling or puffiness of the face
- Swelling of the hands, feet, or lower legs
- Rapid weight gain
- Fainting
- Breathing problems
- Fast or irregular heartbeat
- Tightness in the chest.
Other side effects do not require emergency medical care, but should have medical
attention. If any of the following side effects occur, stop taking the medicine and call
the physician who prescribed the medicine as soon as possible:
- Severe pain, cramps, or burning in the stomach or abdomen
- Convulsions
- Fever
- Severe nausea, heartburn, or indigestion
- White spots or sores in the mouth or on the lips
- Rashes or red spots on the skin
- Any unusual bleeding, including nosebleeds, spitting up or vomiting blood or dark
material
- Black, tarry stool
- Chest pain
- Unusual bruising
- Severe headaches
A number of less common, temporary side
effects are also possible. They usually do not need medical attention and will disappear
once the body adjusts to the medicine. If they continue or interfere with normal activity,
check with the physician. Among these side effects are:
- Gas, bloating, or constipation
- Bitter taste or other taste changes
- Sweating
- Restlessness, irritability, anxiety
- Trembling or twitching.
Interactions with Nonsteroidal anti-inflammatory drugs / NSAIDS
Nonsteroidal anti-inflammatory drugs may interact with a variety of other medicines.
When this happens, the effects of the drugs may change, and the risk of side effects may
be greater. Anyone who takes these drugs should let the physician know all other medicines
he or she is taking. Among the drugs that may interact with nonsteroidal anti-inflammatory
drugs are:
- Blood thinning drugs, such as warfarin (Coumadin)
- Other nonsteroidal anti-inflammatory drugs
- Heparin
- Tetracyclines
- Cyclosprorine
- Digitalis drugs
- Lithium
- Phenytoin (Dilantin)
- Zidovudine (AZT, Retrovir).
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