By Dr. Jonathan Wood

NSAIDs (pronounced "en seds")
Common drugs that come with some simple cautions

Some facts about non-steroidal anti-inflammatory drugs, aka "NSAIDs":
· Used by more than 17 million Americans on a daily basis, making them one of the most commonly used class of drugs in the world
· Very effective pain medications, especially for joint and muscle problems
· Very effective for fever control
· With the increased age of the population and increased prevalence of degenerative and inflammatory joint conditions, their use is anticipated to increase even further
· There are several classes of NSAIDs, all working on the same biological pathway

There many NSAID varieties and many names to keep track of. This is made more confusing by the common uses of both generic and trade names., over-the-counter and prescription.
Some prominent examples: (generic name given with trade names in parentheses)
o Over the counter:
§ Aspirin and other "salicylates" (e.g. Bayer, Bufferin, Excedrin)
§ Ibuprofen (Advil, Motrin)
§ Naproxen (Naprosyn, Aleve)
§ Ketoprofen (Orudis KT) (in some locations)
o Prescription:
§ Etodolac (Lodine)
§ Ketorolac (Toradol)
§ Piroxicam (Feldene)
§ Sulindac (Clinoril)
§ Celecoxib (Celebrex)

It is very important to know that all these medicines belong to the same class of medicine (NSAID) and should not be used at simultaneously. This is particularly important given that a number of these can be purchased without a prescription.

There are several other NSAIDs not included above. If you are unsure about a pain medicine you are taking, simply ask your doctor if it is classified as an NSAID.


The most common side effects of NSAIDs are as follows. If you have concerns about any of these, you should discuss them with your doctor.
· Stomach upset and, in the worst cases, ulcer disease or bleeding. Thankfully, this side effect is less with some of the newer NSAIDs and can be minimized in most cases by taking NSAIDs with food.
· Kidney problems - this is most pronounced in people with underlying kidney disease, but can also happen in normal people who take NSAIDs while dehydrated.

· Blood pressure - again, this is especially important if someone has blood pressure problems. Use of NSAIDs can worsen this, mostly by interfering with blood pressure medicine.
· Liver toxicity - high dose NSAIDs used long term can affect the liver.


If you have any of the following conditions, NSAIDs may be particularly troublesome for you and you should discuss NSAID use with your doctor.
** REMEMBER - - this includes non-prescription NSAIDs **
· Hypertension (high blood pressure)
· Cardiovascular disease
· Ulcer disease
· Gastrointestinal bleeding
· Kidney disease
· Preoperative - surgeons often want to stop NSAIDs in the week prior to surgery


Important TAKE AWAY messages:
1. Take note of the long list of NSAIDs and make sure you are not inadvertently "doubling up", especially with a non-prescription (over the counter) NSAID.
2. Take special care in the hot weather or during exercise not to become dehydrated while taking NSAIDs. This significantly increases the incidence of kidney problems.
3. Be sure to discuss all your medications with your doctor, including over the counter non-prescription medications. These count too!!!
4. If any concern about any of the above or about conditions not mentioned above, discuss NSAIDs with your doctor.


These are GREAT medicines and have changed the life of many patients with painful joint and muscle conditions. Use them carefully and they can serve you well.

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