Taking NSAIDs Safely

When you have a headache or muscle pain, you may reach for an over-the-counter remedy. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a common choice. But even though you can buy them without a prescription, that doesn’t mean they don't have risks. Here’s what you need to know to use them safely.

What are NSAIDs?

NSAIDs are a type of medicine used to treat pain and swelling (inflammation). They can also reduce fever. Lower-dose versions can be bought over the counter. Higher doses may be prescribed for long-term (chronic) conditions. These include rheumatoid arthritis and osteoarthritis. These are some of the most common NSAIDs:

Aspirin
Ibuprofen
Naproxen
Celecoxib
Ketoprofen
Indomethacin

How do NSAIDs work?

NSAIDs keep the body from using COX-1 and COX-2 enzymes. These enzymes make prostaglandins. These are a group of fatty acids in the body. These fatty acids play a major part in pain and inflammation.

What are their risks?

NSAIDs can cause bleeding in the stomach. This is more likely to occur if you take higher doses for a long period of time. Be sure to eat something before taking NSAIDs. This will protect your stomach by coating it. Your healthcare provider might also prescribe a proton pump inhibitor (PPI) to decrease your stomach acid.

NSAIDs may also raise your risk for heart attack, heart failure, and stroke. The FDA requires that the packaging of NSAIDs have a warning about this serious health risk. People who already have heart disease are most at risk. But anyone who takes NSAIDs is at risk.

NSAIDs can also cause kidney damage. If you have chronic kidney disease, only use NSAIDs if your healthcare provider says it’s OK. Use the lowest dose for the shortest amount of time possible. If you need to use NSAIDs for a long time, do so only with your healthcare provider's close direction.

How can you protect yourself?

In general, over-the-counter NSAIDs are safe to ease occasional aches and pains. But you still need to be smart about using them. Follow these tips to minimize any side effects or health risks:

Talk with your healthcare provider or pharmacist first. Tell them about all the prescription and over-the-counter medicines you take. They can tell you if an NSAID is not safe for you. NSAIDs can interact with some medicines. These include medicines used to treat depression and high blood pressure.
Keep track of your doses and timing. Take only the advised amount for the shortest period of time needed. Higher doses can make health problems more likely. Tell your healthcare provider if you take the medicine for 10 days or more.
Read all medicine labels. Don't take 2 or more over-the-counter products with the same active ingredient. You’re more likely to have side effects or an overdose. Read the Drug Facts label first before taking more than 1 over-the-counter medicine. Note that some cough and cold medicines contain NSAIDs.
Don't take NSAIDs if you take daily aspirin. Taking both NSAIDs and aspirin together can raise your risk for side effects, especially stomach bleeding.
Be aware of symptoms such as stomach problems, kidney problems, high blood pressure, heart issues, and rashes.