In addition to corticosteroids, there are many other drugs to reduce inflammation. In particular, they include non-steroidal anti-inflammatory drugs, although the range of their use is not confined to alleviating inflammation. What are the essence of NSAIDs, their benefits and side effects?
What Are Non-Steroidal Anti-Inflammatory Drugs?
Non-steroidal anti-inflammatory drugs (NSAIDs) belong to a class of medications that is very common today. Most NSAIDs relieve pain, hyperthermia and reduce inflammation. NSAIDs are also called “non-opioid analgesics”. This testifies that they are a specific type of painkillers different from opioid drugs like morphine (Infumorph, Kadian, Grumorph, Morphgesic SR, MSIR, MXL, Oramorph SR, RMS brand names), which are used for reducing a more serious type of pain.
These drugs prevent interference with hormone-like active compounds — prostaglandins — from fermentation. An enzyme known as cyclooxygenase (COX) is responsible for the creation of these substances. The availability of prostaglandins is one of the most important factors of the development of inflammatory processes in the body.
Various types of cyclooxygenase are known. COX-1 protects stomach tissues from the corrosive environment of digestive juices. COX-2 is involved in inflammatory reactions in the joints. Such popular NSAIDs as aspirin, ibuprofen, and naproxen block both types of enzymes – both 1 and 2.
The most well-known NSAIDs include the following drugs:
Aspirin. It is a non-steroidal anti-inflammatory medicament. The main active agent is acetylsalicylic acid (acetylsalicylate). It reduces fever, relieves pain, and lowers inflammatory processes. According to the instructions, They recommend that users consume the medicine orally without chewing after the main meal; washing it down with water. The “cycle” shouldn’t exceed 5 days.
Ibuprofen. This NSAID, which is a derivative of propionic acid, inhibits the formation of prostaglandins and has antipyretic, anti-inflammatory and analgesic properties. In addition, ibuprofen reversibly inhibits platelet aggregation caused by ADP (adenosine diphosphate) and collagen. This means it has a diluting effect. They intend the drug for short-term administration in the form of pills.
Naproxen (Aleve, Naprosyn). It has a pronounced anti-inflammatory effect. The active substance can decrease the activity of the enzyme named cyclooxygenase (we mentioned it above), which leads to the disturbance of prostaglandin synthesis. At the start of the therapy and in acute situations, they prescribe adults a daily dose of 0.5-1 mg, the frequency of intake is 2 times a day (in the morning and in the evening). The maintenance amount is 500 mg a day in 1 or 2 dosages.
All the above three meds are OTC in most countries. Other NSAIDs include such drugs as indomethacin (Indocin), oxaprozin (Daypro), piroxicam (Feldene), and others.
Paracetamol (acetaminophen) is usually not referred to as NSAID because it has weaker anti-inflammatory actions. It reduces pain mainly by suppressing COX-2 primarily in the CNS, but not in the rest of the organism.
The use of non-steroidal anti-inflammatory drugs
The meds can help in treating the following diseases:
- Rheumatoid arthritis
- Reactive arthritis, psoriatic arthritis, bursitis, and tendonitis, although their usage is not rigorously proven (Leslie J Crofford, Vanderbilt University, 2013)
- Tension-type headache, migraines, neuropathies
- Renal and biliary colic
- Pain (back, neck, postoperative, etc.)
- Fever (usually at a temperature above 38.5 °C)
They are counter-indicated for individuals with peptic ulcers (especially exacerbated ones) and stomach bleeding. Several “gastroprotective” pharmaceuticals like omeprazole, esomeprazole, ebrotidine have been developed or tested to lessen gastrointestinal toxicity of NSAID meds – the so-called NSAID gastropathy (Ares JJ, Outt PE., Procter & Gamble, 1998).
Other contraindications include severe liver and kidney dysfunctions, cytopenia, individual intolerance, and during child-bearing (typically).
Side Effects of Non-Steroidal Anti-Inflammatory Drugs
An important issue in prescribing anti-inflammatories is their safety. This is because many patients, who need active analgesic therapy, have a high risk of complications that can develop in the stomach, intestines, colon, and the cardiovascular system. That is why when choosing NSAIDs, pharmacological properties of the medication and the specificity of the clinical situation should be taken into account.
NSAIDs may cause the following side effects:
- Decreased appetite
- Increased risk of ulceration
- Heart attack
A study by Patompong Ungprasert, Narat Srivali et al. (published at Rheumatology [Oxford], 2015) showed that folks who used anti-inflammatory painkillers might be at higher risk for venous clots.
Some experts are negative about NSAIDs. For instance, some of them believe that up to the age of 40 you should not use aspirin with viral infections, only paracetamol. Its use can cause Ray’s syndrome. This is a severe dermal-hepatic-renal complication, which can cause a fatal outcome. This view is radical. If these drugs were so dangerous, they would not be over-the-counter. But, we should treat them with some caution.
On our site, you can also read about the side effects of steroids.
The Bottom Line on Anti-Inflammatory Meds
A lot of NSAIDs are OTC medical remedies. You can buy them at the pharmacy without a doctor’s prescription. However, you should be careful when using them in particular if you suffer from gastrointestinal tract diseases (gastritis, ulcer of the stomach or duodenum) because they can cause serious exacerbation. Therefore, consult your doctor before taking them.