Hippocrates — BCE first reported using willow bark  and in 30 BCE Celsus described the signs of inflammation and also used willow bark to mitigate them. On 25 April , Edward Stone wrote to the Royal Society describing his observations on the use of willow bark-based medicines in febrile patients.
By , French chemist Henri Leroux had improved the extraction process to obtain about 30g of purified salicin from 1. By hydrolysis , salicin releases glucose and salicyl alcohol which can be converted into salicylic acid , both in vivo and through chemical methods.
In , Hermann Kolbe synthesised salicylate, although it was too acidic for the gastric mucosa. By the German chemist Felix Hoffmann and the Bayer company prompted a new age of pharmacology by converting salicylic acid into acetylsalicylic acid—named aspirin by Heinrich Dreser. While studies have been conducted to see if various NSAIDs can improve behavior in transgenic mouse models of Alzheimer's disease and observational studies in humans have shown promise, there is no good evidence from randomized clinical trials that NSAIDs can treat or prevent Alzheimer's in humans; clinical trials of NSAIDs for treatment of Alzheimer's have found more harm than benefit.
Research supports the use of NSAIDs for the control of pain associated with veterinary procedures such as dehorning and castration of calves. For example, ketoprofen 's effects have been studied in horses more than in ruminants but, due to controversy over its use in racehorses, veterinarians who treat livestock in the United States more commonly prescribe flunixin meglumine , which, while labeled for use in such animals, is not indicated for post-operative pain.
In the United States, meloxicam is approved for use only in canines, whereas due to concerns about liver damage it carries warnings against its use in cats   except for one-time use during surgery. From Wikipedia, the free encyclopedia. Class of drug. Osteoarthritis    Rheumatoid arthritis  Mild-to-moderate pain due to inflammation and tissue injury  Low back pain   Inflammatory arthropathies e.
Peptic ulcer or stomach bleeding  Uncontrolled hypertension  Kidney disease  People that suffer with inflammatory bowel disease Crohn's disease or ulcerative colitis  Past transient ischemic attack excluding aspirin  Past stroke excluding aspirin  Past myocardial infarction excluding aspirin  Coronary artery disease excluding aspirin  Undergoing coronary artery bypass surgery  Congestive heart failure excluding low-dose aspirin  In third trimester of pregnancy  Persons who have undergone gastric bypass surgery   Persons who have a history of allergic or allergic-type NSAID hypersensitivity reactions , e.
Indomethacin Tolmetin Sulindac Etodolac Ketorolac  Diclofenac Aceclofenac Bromfenac Nabumetone drug itself is non-acidic but the active, principal metabolite has a carboxylic acid group. Mefenamic acid Meclofenamic acid Flufenamic acid Tolfenamic acid. This section does not cite any sources. Please help improve this section by adding citations to reliable sources. Unsourced material may be challenged and removed. July Learn how and when to remove this template message.
Ovid Technologies Wolters Kluwer Health. PMID Non-steroidal anti-inflammatory drugs NSAIDs are the competitive inhibitors of cyclooxygenase COX , the enzyme which mediates the bioconversion of arachidonic acid to inflammatory prostaglandins PGs. PMC S2CID Australian Prescriber.
American Journal of Nephrology. The Physician and Sportsmedicine. Page, Michael J. Australian medicines handbook ISBN Comparing effectiveness, safety, and price. Annals of the Rheumatic Diseases. The Cochrane Database of Systematic Reviews.
Controlled Clinical Trials. Journal of Paramedic Practice. Retrieved 2 June Wissenschaftliche Verlagsgesellschaft Stuttgart. Pain Research and Treatment. Drug Design, Development and Therapy. British National Formulary. Retrieved 28 August The American Journal of Gastroenterology. Archived from the original PDF on 4 March Retrieved 18 October October Retrieved 2 February World Journal of Surgery. The British Journal of Surgery. Clinical Cornerstone. Retrieved 31 August Retrieved 15 October This article incorporates text from this source, which is in the public domain.
Food and Drug Administration. Archived from the original on 29 January November The New England Journal of Medicine. Meta-analysis of randomised trials". January May August Archives of Internal Medicine. Retrieved 9 July The Journal of Urology. April Retrieved 21 July MedPage Today. July Journal of Gastroenterology. Acta Pharmacologica Sinica. Journal of Clinical Gastroenterology.
The Medical Journal of Australia. Drug Safety. Expert Opinion on Pharmacotherapy. Human Reproduction. Southern Medical Journal. France Soir in French. Archived from the original on 9 June Retrieved 1 June Orthopaedic Journal of Sports Medicine.
The American Journal of Sports Medicine. ISSN JBJS Reviews. American Journal of Epidemiology. The American Journal of Medicine. Retrieved 27 April Use acetaminophen. Do not take pain relievers that contain aspirin and ibuprofen Advil , it may lead to a greater tendency to bleed. The Economic Times.
Handb Clin Neurol. Handbook of Clinical Neurology. Immunology and Allergy Clinics of North America. Clinical Pharmacokinetics. Archived from the original on 16 January Retrieved 30 November Retrieved 29 January Bibcode : PNAS.. Journal of the American Chemical Society. Porto Biomedical Journal. Issue 5.
Bhattacharya , Y. Akula, G. Mitongo, Q. Cellular Immunology. Expert Review of Clinical Pharmacology. Retrieved 17 February Iranian Journal of Pharmaceutical Research. Journal of Physiology and Pharmacology. British Journal of Pharmacology. The Journal of Biological Chemistry. Current Molecular Pharmacology. Journal of Clinical Rheumatology. Current Medicinal Chemistry. The Yale Journal of Biology and Medicine. Medicinal Chemistry, 2nd Edition. Pearson Education India, Archived from the original on 19 November Retrieved 8 March Archived from the original on 27 May Archived from the original on 2 February BMJ Open.
National Center for Biotechnology Information. Published by Cengage Learning Editores, McGraw-Hill Interamericana. Annalen der Chemie und Pharmacie. Schmitt Journal of Alzheimer's Disease. European Journal of Inorganic Chemistry. Archived from the original PDF on 25 August Retrieved 24 July NSAIDs are also used for a number of other conditions, ranging from acute headaches to ankylosing spondylitis.
Prostaglandins have other effects in the body, too. They help maintain the mucosal lining of the stomach and intestines, promote blood clotting, and help the kidneys function normally. Because prostaglandins have many roles in the body, taking NSAIDs to suppress the production of prostaglandins can have both positive and negative effects. See Trouble Swallowing Pills Dysphagia. NSAIDs should be used cautiously when taken for more than a few days in a row.
People are advised to:. See Acetaminophen for Back Pain. Any adverse reactions from taking an NSAID, or any other medication, should be reported to the doctor without delay. NSAIDs are also not advised for people who are taking anticoagulant medication blood thinners or who have kidney disease. Many doctors also tell patients to stop using NSAIDs prior to other types of surgery because the medication poses an increased risk of bleeding.
Medications for Back Pain Video. Potential Risks and Complications of Celecoxib.
Be aware that websites from other countries may have information that differs from New Zealand recommendations. NSAIDs are often used for pain relief and can generally be safely used, but they may cause harm in some people. Before you use these medicines, weigh the risks and other side effects carefully — check with your pharmacist or doctor if they are suitable for you.
NSAIDs sometimes cause the lining of the stomach to bleed. This is because the chemicals prostaglandins that are reduced by anti-inflammatories are also involved in helping to protect the lining of the stomach from the effects of the acid within the stomach. Studies have shown that all NSAIDs, except aspirin in low doses, can increase the chance of heart attack or stroke.
Examples of ACE inhibitors are captopril, cilazapril, enalapril, lisinopril, perindopril and quinapril. Examples of ARB blockers are candesartan and losartan. Examples of diuretics are furosemide, bumetanide, bendroflumethiazide, chlortalidone, indapamide and metolazone.
Read more about the harmful effects of the triple whammy. NSAIDs can raise blood pressure in some people. Some people with high blood pressure hypertension may have to stop taking NSAIDs, if they notice that their blood pressure increases even if they are taking their blood pressure medications and following their diet. NSAIDs can cause symptoms of asthma to worsen such as cough, wheezing, shortness of breath.
NSAIDs may increase the risk of miscarriage if used in early pregnancy. NSAIDs should also be avoided during the third trimester because they may affect the large blood vessels of the developing baby. It is generally recommended to avoid the use of NSAIDs during pregnancy unless the benefit justifies the risk. The following links provide further information about ibuprofen.
Looking for Where to get medical help A health professional or service Patient portals Newsletters View all. The main risks of NSAIDs include its effects on: the stomach the heart the kidneys blood pressure asthma pregnancy. Ulcers and stomach bleeding can happen without any warning symptoms. Effects on the heart Studies have shown that all NSAIDs, except aspirin in low doses, can increase the chance of heart attack or stroke.
The risk may be greater if you have heart disease or you have risk factors for heart disease such as smoking, high blood pressure, high cholesterol, diabetes. Prostaglandins have other effects in the body, too.
They help maintain the mucosal lining of the stomach and intestines, promote blood clotting, and help the kidneys function normally. Because prostaglandins have many roles in the body, taking NSAIDs to suppress the production of prostaglandins can have both positive and negative effects. See Trouble Swallowing Pills Dysphagia. NSAIDs should be used cautiously when taken for more than a few days in a row.
People are advised to:. See Acetaminophen for Back Pain. Any adverse reactions from taking an NSAID, or any other medication, should be reported to the doctor without delay. NSAIDs are also not advised for people who are taking anticoagulant medication blood thinners or who have kidney disease.
Many doctors also tell patients to stop using NSAIDs prior to other types of surgery because the medication poses an increased risk of bleeding. Medications for Back Pain Video. Potential Risks and Complications of Celecoxib. Pulled Back Muscle Treatment.
Tell your doctor or pharmacist if you have any of the risk factors above before buying or taking an NSAID. Alcohol can irritate the stomach lining. Regular or heavy drinking of alcohol while taking NSAIDs may increase the risk of gastrointestinal damage or bleeding. If you are taking another medicine, check with your health professional before taking a NSAID in case you might be at risk of unwanted effects. Some over-the-counter medicines contain NSAIDs, for example, pain relief medicines and some cough, cold and flu medicines.
Do not take more than one medicine containing an NSAID at the same time, unless your doctor recommends it. If you are taking any over-the-counter NSAIDs, tell your doctor or pharmacist, particularly if you are due to undergo surgery or are starting a new medicine.
This page has been produced in consultation with and approved by:. Ankylosing spondylitis AS is a type of inflammatory arthritis that targets the joints of the spine. Antioxidants scavenge free radicals from the body's cells, and prevent or reduce the damage caused by oxidation.
Antipsychotic medications work by altering brain chemistry to help reduce psychotic symptoms like hallucinations, delusions and disordered thinking. One child in every 1, in Australia is diagnosed with juvenile arthritis. It is one of the most common chronic conditions to affect children.
No special diet or 'miracle food' can cure arthritis, but some conditions may be helped by avoiding or including certain foods. Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional.
The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances.
The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. Skip to main content. Home Medications. Medications - non-steroidal anti-inflammatory drugs. Actions for this page Listen Print.
Summary Read the full fact sheet. On this page. How NSAIDs work Prostaglandins are hormone-like chemicals in the body that contribute to inflammation, pain and fever by raising temperature and dilating blood vessels, which causes redness and swelling in the place they are released. Other common side effects of NSAIDs include: raised liver enzymes detected by a blood test, this is more commonly associated with diclofenac than other NSAIDs diarrhoea headache dizziness salt and fluid retention high blood pressure.
Less common side effects include: ulcers of the oesophagus food pipe rectal irritation if suppositories are used heart failure hyperkalaemia high levels of potassium in the blood reduced kidney function confusion bronchospasm difficulty breathing skin rash skin irritation, reddening, itching or rash if skin products are used, such as a cream. NSAIDs can provide relief While NSAIDs can potentially cause many side effects — some of which may be serious or life-threatening — if prescribed under the right conditions and used as instructed, they can be of great benefit.
Risk factors include: increasing age side effects are more common in people aged 65 years and over asthma previous or current gastrointestinal problems such as ulcers, bleeding or Helicobacter pylori infection the germ that can cause ulcers having particular heart problems for example, heart failure , high blood pressure, diabetes or kidney disease drinking alcohol taking high doses of NSAIDs taking NSAIDs for more than a few days at a time a previous allergic reaction to NSAIDs taking certain other medicines while taking NSAIDs.
NSAIDs can cause kidney failure when they are combined with ACE inhibitors medicines used to treat heart problems and high blood pressure and diuretics medicines to remove excess fluid. NSAIDs can oppose the effects of medicines for heart failure and high blood pressure and stop them working effectively, including ACE inhibitors, beta blockers and diuretics. Anti-inflammatory painkillers are sometimes called non-steroidal anti-inflammatory drugs NSAIDs , or just 'anti-inflammatories'.
Anti-inflammatory painkillers include: aceclofenac , acemetacin , aspirin see also below , celecoxib , dexibuprofen , dexketoprofen , diclofenac , etodolac , etoricoxib , fenoprofen , flurbiprofen , ibuprofen , indometacin , ketoprofen , mefenamic acid , meloxicam , nabumetone , naproxen , sulindac , tenoxicam , and tiaprofenic acid.
Each of these also comes as different brand names. You need a prescription to obtain anti-inflammatories, apart from ibuprofen and aspirin, which you can also buy from pharmacies. After a single dose, they work at least as well as paracetamol to ease pain. A short course of an anti-inflammatory medicine is an option to ease short bouts of painful conditions. Ibuprofen and aspirin are also used to bring down a high temperature.
Low-dose aspirin is also used to help prevent blood clots that can cause a heart attack or stroke. See the separate leaflet called Aspirin and Other Antiplatelet Medicines. They work by blocking inhibiting the effect of chemicals enzymes called cyclo-oxygenase COX enzymes.
COX enzymes help to make other chemicals called prostaglandins. Some prostaglandins are involved in the production of pain and inflammation at sites of injury or damage. A reduction in prostaglandin production reduces pain and inflammation. It is the COX-2 enzyme that is mainly involved in making the prostaglandins that are involved with pain and inflammation. Anti-inflammatory painkillers are sometimes classified into two main groups:. It is often worth trying paracetamol before taking an anti-inflammatory.
Paracetamol is a good painkiller, and is less likely to cause side-effects. Although paracetamol does not reduce inflammation, it is often the preferred painkiller for muscle and joint conditions that cause pain but have little inflammation. For example, osteoarthritis.
See separate leaflet called Painkillers. If you take an anti-inflammatory painkiller, as a rule you should take the lowest dose that is effective, for the shortest length of time that is possible. The aim is to ease pain and inflammation but with the least risk of developing side-effects.
However, some people take one long-term - for example, some people who have an inflammatory arthritis where an anti-inflammatory gives great relief of symptoms. In this situation, the need for long-term treatment should be reviewed by a doctor from time to time. Before starting a course of an anti-inflammatory painkiller, your risk of developing serious cardiovascular heart, stroke or blood vessel and gut side-effects should be taken into account see below.
Anti-inflammatories do not alter the course of painful conditions such as arthritis. They just ease symptoms of pain and stiffness. However, this may provide further benefit because, if pain is eased, you may then be able to move around more easily or use a painful joint more easily. The inflammation and pain of various types of arthritis often come and go. During good spells, when symptoms are not too bad, you may not need to take anti-inflammatories. The different types of anti-inflammatories have pros and cons which is why different people take different ones.
For example:. Some people find that one preparation works better than another for them. If one preparation does not work very well at first, then a different one may work better. It is not unusual to try two or more preparations before finding one that suits you best. Your doctor can advise. Anti-inflammatories can also be given topically as a cream or ointment which you rub into the effected area. See the separate leaflet called Topical Anti-inflammatory Painkillers.
You may also be advised to use anti-inflammatory painkillers with heat and ice treatment for pain. See the separate leaflet called Heat and Ice Treatment for Pain. They conclude that:. Most people who take anti-inflammatories have no side-effects, or only minor ones.
When taken appropriately, the benefit usually far outweighs the potential harms. In particular, many people take a short course of an anti-inflammatory for all sorts of painful conditions. However, side-effects, and sometimes very serious possible adverse effects, can occur. Therefore, do read the leaflet that comes with the tablets for a full list of cautions and possible side-effects. In particular, check if you have any of the conditions or take other medicines where the risk of side-effects is increased.
For example, one important caution is that, ideally, you should not take anti-inflammatories if you are pregnant. Also, if you have any cardiovascular heart, stroke or blood vessel condition, or certain gut conditions, or are elderly, they are prescribed with caution and only if there are no alternatives, and at the lowest doses and durations necessary.
The following is not an exhaustive list but highlights some of the more important side-effects and cautions to be aware of. Anti-inflammatories sometimes cause the lining of the stomach to bleed. This is because the chemicals prostaglandins that are reduced by anti-inflammatories are also involved in helping to protect the lining of the stomach from the effects of the acid within the stomach.
Sometimes a stomach ulcer develops. Sometimes bleeding is severe, and even life-threatening. Elderly people are more prone to this problem but it can occur in anybody. Therefore, if you are taking an anti-inflammatory and you develop upper tummy abdominal pains, pass blood or black stools faeces , or bring up vomit blood, stop taking the tablets.
Then, see a doctor urgently, or go to a casualty department. The risk of bleeding into the stomach is increased if you are taking an anti-inflammatory plus warfarin , steroids , or low-dose aspirin used by many people to help prevent a heart attack or stroke. These combinations of medicines should only be used if absolutely necessary. Some people need an anti-inflammatory to ease pain, and yet are at increased risk of stomach bleeding. For example, people aged over 65, or those with a past history of a stomach or duodenal ulcer.