Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are medicines that relieve pain, swelling, stiffness, and inflammation. They are prescribed for a variety ofpainful conditions, including arthritis, bursitis, tendinitis, gout, menstrual cramps, sprains, strains, and other injuries. Two drugs in this category,ibuprofen and naproxen, also reduce fever. While NSAIDs relieve symptoms, they do not cure the diseases or injuries responsible for these problems. Some nonsteroidal anti-inflammatory drugs can be bought over the counter; others are available only with a prescription from a physician or dentist.

Among the drugs in this group are diclofenac (Voltaren), etodolac (Lodine), flurbiprofen (Ansaid), ibuprofen (Motrin, Advil, Rufen), ketorolac (Toradol),nabumetone (Relafen), naproxen (Naprosyn); naproxen sodium (Aleve, Anaprox, Naprelan); and oxaprozin (Daypro). They are sold as tablets, capsules, caplets, liquids, and rectal suppositories and some are available in chewable, extended-release, or delayed-release forms.

NSAIDs should always be taken as directed. Patients who take this medicine for severe arthritis must take it regularly over a long time. Several weeks maybe needed to feel the results, so it is important to keep taking the medicine, even if it does not seem to be working at first.

When taking NSAIDs in tablet, capsule, or caplet form, always take them witha full, 8-ounce glass of water or milk. Taking these drugs with food or an antacid will help prevent stomach irritation.

NSAIDs can cause a number of side effects, from indigestion, dizziness, drowsiness and heartburn to more serious problems such as fast heartbeat, tightness in the chest, convulsions, and unusual bleeding. Most minor symptoms go away as the patient's body adjusts to the medicine. If they do not, or if severeside effects occur, call a physician.

Side effects are more likely when the drugs are taken in large doses or for along time or when two or more nonsteroidal anti-inflammatory drugs are takentogether. Also, older people may be more likely than younger people to haveside effects. Health care professionals can help patients weigh the risks ofbenefits of taking these medicines.

Some NSAIDs can increase the chance of bleeding after surgery (including dental surgery), so anyone who is taking the drugs should alert the physician ordentist before surgery. It may be necessary to stop taking the medicine or toswitch to another type several days before surgery.

NSAIDs make some people more sensitive to sunlight. Even brief exposure to sunlight can cause severe sunburn, rashes, redness, itching, blisters, or discoloration. Vision changes also may occur. To reduce the chance of these problems, avoid direct sunlight, especially from mid-morning to mid-afternoon; wearprotective clothing, a hat, and sunglasses; and use a sunscreen with a skinprotection factor (SPF) rating of at least 15. Do not use sunlamps, tanning booths or tanning beds while taking these drugs.

NSAIDs may interact with a variety of other medicines. When this happens, theeffects of the drugs may change, and the risk of side effects may be greater. Anyone who takes these drugs should let the physician know all other medicines he or she is taking. Among the drugs that may interact with NSAIDs are:

  • Blood thinning drugs, such as warfarin (Coumadin)
  • Other nonsteroidal anti-inflammatory drugs
  • Heparin
  • Tetracyclines
  • Cyclosprorine
  • Digitalis drugs
  • Lithium
  • Phenytoin(Dilantin)
  • Zidovudine (AZT, Retrovir).

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