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Nonsteroidal anti-inflammatory drugsNonsteroidal anti-inflammatory drugs, more commonly called NSAIDs (pronounced En-sayds), reduce inflammation and relieve pain. The most widely used NSAID is ibuprofen (e.g. Brufen, Nurofen). This is available in non-prescription medicines such as Nurofen and Advil and prescription products such as Brufen (although it is mostly dispensed supplied as an unbranded 'generic' medicine). All other NSAIDS for oral use are prescription only.
How do NSAIDs work?They work by blocking the production of chemicals in the body known as 'prostaglandins'. These chemicals are produced as a normal body function and are involved in pain transmission, inflammation and tissue damage.  What are they for?NSAIDs can be used simply to relieve mild to moderate pain due to many things, such as headache, backache, toothache, period pains, surgery and sports injuries. But, because they also reduce inflammation and swelling, NSAIDs are often given for inflammatory conditions like arthritis and other rheumatic diseases. Side effectsIndigestion, heartburn, feeling or being sick and diarrhoea are common with NSAIDs taken by mouth. Ibuprofen is among the NSAIDS least likely to cause these problems. Azapropazone is noted as being the most likely. Occasionally, bleeding and ulceration in the stomach can also occur. Other less common side effects include ankle swelling, headache, dizziness, vertigo (a sensation of spinning), tinnitus (ringing in the ears) and unusual bruising or bleeding. NSAIDs can also cause allergic reactions such as skin rashes and wheezing. NSAID preparations applied to the skin can commonly cause reddening, smarting, itching and skin rashes. Tell your doctor or pharmacist if you develop any of these, or other, side effects. Contact your doctor immediately if you have stomach pains or cramps, vomit blood or something that looks like coffee grounds, or if you have bloody or black, tar-like stools. When to avoid NSAIDsYou should avoid using NSAIDs if you:
Use NSAIDs with care if ...You should use NSAIDs with care if you:
Interactions with other medicinesIf you take any other medicines or herbal remedies, including those you have bought without a prescription, talk to your doctor or pharmacist before taking an NSAID. This is because NSAIDs can:
How to use NSAIDsNSAIDs can be given by injection, taken by mouth (e.g. as liquid, tablets or capsules), or applied to the skin in creams, gels or ointments. Ideally, you should take oral NSAIDs with or after food, as this can help to minimise the stomach side effects. You should also avoid alcohol because it too irritates the stomach lining and increases the risk of stomach upsets. Oral ibuprofen (e.g. Advil, Cuprofen, Ibuleve, Nurofen) can be bought without a prescription from pharmacies and (in small amounts) from other general shops and supermarkets. Don't exceed the doses recommended on the packet. Most other NSAID preparations are only available with a prescription. The exceptions are a few gels that are applied to the skin - felbinac (Traxam), ketoprofen (Oruvail, Solpaflex) or piroxicam (Feldene). These can be rubbed gently into the painful area three or four times a day for up to a week. They are not suitable for children and should not be applied to broken or infected skin, near the eyes or mouth, under plasters or dressings, or in the same place as other skin preparations. NSAIDs for childrenA liquid form of ibuprofen, containing 100mg of the medicine per 5ml, (e.g. Nurofen For Children) can be given to children over 6 months old, and to younger babies on the advice of a doctor. It can be useful after immunisations. Most other NSAIDS should not be used in children under 12, except under the supervision of a doctor. Prescription-only NSAIDs(The black triangle symbol indicates drugs that are new to the market. This is intended to remind doctors and pharmacists to be particularly vigilant about side effects associated with taking these medicines. At present, the black triangle does not appear on information for patients.)
NSAIDs abroadTravellers to other countries may find NSAIDs other than ibuprofen are available without prescription. For example, in the United States, naproxen and ketoprofen can be bought 'over-the-counter' in drug stores. June 2001 Back to Medicines index.
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