Nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce pain and inflammation. A list of common NSAIDs includes ibuprofen, aspirin, and naproxen.

Though there are a variety of different NSAIDs available both over-the-counter (OTC) and via prescription.

For short-term use, NSAIDs are generally safe. However, certain people, such as those in their third trimester of pregnancy or people with kidney problems, should avoid using them.

Long-term NSAID use may increase the risk of adverse reactions, such as stomach bleeding.

This article includes the different NSAID types, a list of NSAIDs, their possible side effects, and drug interactions.

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Scientists categorize NSAIDs based on their chemical structure and selectivity. They includeTrusted Source:

  • acetylated salicylates (aspirin)
  • non-acetylated salicylates (diflunisal, salsalate)
  • anthranilic acids (meclofenamate and mefenamic acid)
  • propionic acids (naproxen and ibuprofen)
  • enolic acids (meloxicam and piroxicam)
  • acetic acids (diclofenac and indomethacin)
  • naphthylalanine (nabumetone)
  • selective COX-2 inhibitors (celecoxib, etoricoxib)

NSAIDs can also be selective or nonselective. To understand these groupings, a person first needs to know how NSAIDs work.

Selective vs. nonselective NSAIDs

NSAIDs mainly reduce a substance known as cyclooxygenase (COX). The body needs COX to convert arachidonic acid into:

  • prostaglandins, which may play a role in opening up blood vessels
  • prostacyclins, which also widen blood vessels
  • thromboxanes, which help platelets in the blood stick together to form clots

These substances also help with temperature regulation and how the body responds to mechanical injuries.

With less COX, a person may have lower levels of these chemicals, which is likelyTrusted Source how NSAIDs work to relieve pain, inflammation, and fever.

There are two types of COX isoenzymes: COX-1 and COX-2. They each play slightly different roles in the body:

  • COX-1: This type helps the body with platelet adhesion, maintains the lining of the gastrointestinal tract, and aids kidney function.
  • COX-2: This type plays a role in the inflammatory response that occurs after injury or illness.

The majority of NSAIDs are nonselective. This means they target both COX-1 and COX-2 isoenzymes. This may lead to different adverse reactions, as they can affect different systems in the body.

Selective NSAIDs only target COX-2. Currently, in the United States, celecoxib is the only selective NSAID available.

By selectively targeting only COX-2, celecoxib can help with inflammation without affecting other systems in the body, such as the kidneys.

Below is a list of NSAIDs available via prescription or OTC. Various factors such as dosage and formula can affect how strong they are.

Prescription-only

Prescription-only NSAIDs include:

  • diclofenac
  • diflunisal
  • etodolac
  • fenoprofen
  • flurbiprofen
  • indomethacin
  • ketoprofen
  • ketorolac
  • mefenamic acid
  • meloxicam
  • nabumetone
  • oxaprozin
  • piroxicam
  • sulindac

Though these NSAIDs may share similar strengths and potential side effects, a person should follow all instructions from a doctor or pharmacist when taking the medications and not assume that if they switch medications, the dosing will be the same.

Available OTC and prescription

Some NSAIDs come in both OTC and prescription forms. Examples include ibuprofen and naproxen.

A person can typically find both OTC ibuprofen and naproxen in brand name and generic forms. Many pharmacies carry a “store brand” that is generally lower cost than brand name options.

Two well-known brand-name carriers of ibuprofen include Advil and Motrin. Aleve is a well-known type of naproxen.

For adults and children older than 12, the typical dose for OTC ibuprofen is 200 milligrams (mg) every 4 to 6 hours, or 400 mg if that does not work.

Naproxen comes in several doses, including 250 mg, 375 mg, and 500 mg. A typical dosage for adults is one to two 220 mg tablets every 8 to 12 hoursTrusted Source.

The exact dose and how frequently a person should take these medications can vary based on the formula and the underlying condition a person or doctor is trying to treat. For example, some formulas are quick-release while others have an extended release, so that they keep working over time.

A person should follow a doctor or pharmacist’s instructions for when and how to take the medications. People should follow the package’s instructions when taking OTC NSAIDs and not exceed the maximum daily dose.

Available OTC

Currently, aspirin is available only in OTC form. Naproxen and ibuprofen are also available OTC.

Like other forms of NSAID, aspirin comes in several different formulas and doses, such as slow-release 81 mg tablets or regular strength tablets. Regular-strength aspirin often comes in 325 mgTrusted Source tablets. A person typically takes 1 or 2 tablets every 4 hours.

A person should always follow the instructions on the package when taking aspirin. Do not give aspirin to children unless a doctor says this is safe.

Rarely, children recovering from chickenpox or who have flu-like symptoms develop a serious condition known as Reye’s syndrome after taking aspirin.

NSAIDs can cause side effects, some of which are potentially seriousTrusted Source. Some possible side effects of NSAIDs include:

  • stomach pain
  • diarrhea or constipation
  • nausea and vomiting
  • tinnitus
  • dyspepsia
  • bloating
  • dizziness
  • nervousness
  • edema, or swelling
  • headache
  • skin rash

NSAIDs can also negatively affect several systems in the body, such as the:

  • gastrointestinal tract
  • kidneys
  • cardiovascular system
  • clotting effect of blood
  • liver, although this is less common

Certain people should avoid NSAID use, such as people with kidney disease or stomach ulcers.

Healthcare professionals should consider the potential benefits and risks when recommending or prescribing NSAIDs.

Drug can cause other medications to work differently by increasing or reducing their effects. This is known as a drug interaction.

NSAIDs can interact negatively with several other medications, such as:

This is not a comprehensive list, so it is always important to discuss medications a person already takes with a doctor before trying a new NSAIDs. If the NSAID is not suitable, a doctor may be able to provide different options.

NSAIDs can help to reduce pain, inflammation, and fever. A person may use them to treat occasional aches and pains, or treat health conditions, such as arthritis.

NSAIDs come in both prescription and OTC strengths. They also come in different formulas that can affect how quickly they work, how long they work, and their dosage. A person should follow all package, doctor, or pharmacist recommendations when taking the medications.