NSAIDs: What You Need to Know
Nonsteroidal anti-inflammatory drugs (NSAIDs) are some of the most commonly used medicines for pain, fever, and inflammation. You’ve likely used ibuprofen or naproxen — both are NSAIDs. They reduce pain by blocking COX enzymes that help make prostaglandins, the chemicals that cause swelling and soreness.
When are NSAIDs useful? They ease headaches, muscle strains, arthritis pain, menstrual cramps, and dental pain. Over-the-counter choices like ibuprofen (200–400 mg every 4–6 hours as needed) and naproxen (220 mg every 8–12 hours) work well for short-term issues. Prescription NSAIDs or higher doses are for chronic inflammatory conditions; your prescriber will advise what’s right for you.
Practical tips for safe use
Use the lowest effective dose for the shortest period that helps. Always read the label or follow your doctor’s directions. Take NSAIDs with food or milk to reduce stomach upset. Don’t combine different oral NSAIDs — taking ibuprofen and naproxen together increases risks without added benefit. Limit alcohol while on NSAIDs; it raises the chance of stomach bleeding.
If you have a history of stomach ulcers, ask about protective options like a proton pump inhibitor (omeprazole) or consider a COX-2 selective drug (celecoxib) if appropriate. Topical NSAID gels can be a good alternative for joint pain because they give local relief with lower systemic exposure.
Who should be careful or avoid NSAIDs
NSAIDs can cause stomach bleeding, worsen kidney function, and raise blood pressure. People with heart disease, uncontrolled hypertension, chronic kidney disease, or those on blood thinners need medical advice before using them. Common drug interactions include ACE inhibitors, diuretics, warfarin, and some antidepressants — these combinations can increase bleeding, kidney trouble, or reduce blood pressure control.
Special groups need extra caution. Pregnant people should avoid most NSAIDs in the third trimester because they can affect the baby’s circulation and labor. Children can use age-appropriate NSAID doses, but never give aspirin to kids with viral illness due to Reye’s syndrome. Older adults often need lower doses and closer monitoring for side effects.
Alternatives include acetaminophen for pain without inflammation, physical therapy, topical treatments, and non-drug options like ice, heat, or TENS. If you rely on pain medicine long-term, talk to your clinician about safe plans and possible tests, such as kidney function and blood pressure checks.
Watch for red flags: black stools, sudden severe stomach pain, unexplained swelling, shortness of breath, or decreased urine output. If any of these happen, stop the NSAID and seek medical help. For ongoing pain, work with a clinician to balance relief and safety and to pick the most suitable option for your health.
