Non-steroidal anti-inflammatory drugs (NSAIDs) are medications that are primarily prescribed to treat pain. They are also effective at reducing swelling and fever relating to various conditions, including flu and auto-immune diseases.
- Treat pain, swelling and fever.
- Available in various types.
- Some are available to buy over the counter, while others require a prescription.
If you have any concerns about pain, you can speak with one of our GMC-registered clinicians via our online video consultation service. Our clinicians are available for appointments between 9.30am-4.30pm, Monday to Friday.
What are NSAIDs?
NSAIDs are available in various forms and strengths, and are prescribed to manage pain symptoms in people with various conditions. These include period pain, colds and arthritis. While these drugs can be effective in many cases, they are not always well tolerated and may not be suitable for some people. Depending on their strength, some NSAIDs are available to buy over the counter, while others require a prescription.
What is period pain?
Period pain is a very common experience during the menstrual cycle, with most women experiencing some level of discomfort. Symptoms include muscle cramps that can spread from the abdomen to the back and legs. The pain can be a constant and dull sensation or present as intense spasms. This may vary from one period to the next, with some cycles producing little to no symptoms of pain.
Period pain is usually caused by contractions that enable the womb to shed its lining, which usually happens once a month. These contractions lead to a lack of oxygen and blood supply in the womb, which causes the release of pain signals and further contractions. Period pain may also be caused by medical conditions, such as pelvic inflammatory disease, fibroids and endometriosis.
How is period pain treated?
Period pain can be managed with painkillers, which range from over the counter tablets such as paracetamol and the NSAID ibuprofen, to prescription medications such as codeine and naproxen. Non-medicinal treatments may also help, such as gentle exercise, stopping smoking and relaxation techniques. Placing heat on the affected area, usually the abdomen or back, is an additional measure that can provide significant relief.
What is the common cold?
The common cold, as its name suggests, is a condition that affects all of us at some point in our lives. It usually resolves itself within a few days or weeks, with symptoms ranging from mild to more flu-like indications.
It’s caused by a virus, which means it can’t be treated with antibiotics (unless it triggers bacterial infections, which can be treated with antibiotics). Symptoms of the common cold include a sore throat, blocked nose, coughing, sneezing, headaches, muscle pain, fever and a loss of sense of taste and smell.
There are several ways to treat a cold, most of which involve rest and avoiding becoming dehydrated. Medications can manage symptoms effectively while the body fights the infection. Decongestant sprays may help to clear the nose and help you to sleep and rest better, which makes it easier for the body to overcome the infection.
Paracetamol and ibuprofen are the most commonly used treatments for symptoms of a cold, however; they reduce fever and relieve some of the pain symptoms associated with such infections.
What is arthritis?
There are many forms of arthritis, but the most common are osteoarthritis and rheumatoid arthritis. Osteoarthritis affects as many as nine million people in the UK, and as such is the most common form. It’s caused by the ends of the cartilage of the bones wearing down and subsequently making it difficult for them to repair. This leads to pain and swelling of the joints.
Rheumatoid arthritis usually presents in the hands, wrists and feet. It’s caused by the immune system attacking the cells that line the joints by mistake. This results in swelling, pain and stiffness, which are similar symptoms to osteoarthritis. Other indications may include fever, sweating and fatigue.
How is arthritis treated?
Both osteoarthritis and rheumatoid arthritis are long-term conditions, and treatment is focused on tackling symptoms and slowing down the progression of the arthritis. A new medication called JK inhibitors can be an effective treatment for rheumatoid arthritis, while exercise and lifestyle changes may help to treat osteoarthritis. Symptoms for conditions can be well managed by using NSAIDs, however. Some NSAIDs are available as a topical cream. If pain is particularly severe, other painkillers, such as opioids, may be prescribed.
If you would like to discuss NSAIDs and any other related conditions with a registered clinician, our online video consultation is available from 9.30am-4.30pm, five days a week. Our clinicians can also issue referrals to specialists for treatment and fit notes, where appropriate.
What side effects can NSAIDs cause?
All medications come with some risk of causing side effects. Your prescribing clinician can clarify what these are for your specific treatment, and any measures you can take to reduce the likelihood of them happening. You can also refer to the patient information leaflet that comes with your medication for any details on side effects.
The following information relates to the NSAID Naproxen, and may not apply to your specific treatment.
If you notice any of the following symptoms you should seek immediate medical attention, as they may indicate an allergic reaction: swelling of your throat, face, hands or feet; difficulty breathing; tightness in your chest; rashes, blisters or itching.
Gut problems: vomiting blood, bleeding from the anus, black sticky bowel motions, bloody diarrhoea, ulcers in the stomach or gut, severely upset stomach, stomach pain, fever, vomiting and nausea.
Pancreas problems: stomach pain which spreads to your back, worsening of ulcerative colitis or Crohn’s disease with diarrhoea, vomiting and weight loss.
Severe skin rashes: a severe rash that develops quickly, blisters, peeling of your skin, blisters in your mouth, throat, eyes, blistering of skin when exposed to sunlight.
Liver problems: yellowing of your skin or the whites of your eyes, fatigue, loss of appetite, nausea, vomiting and pale stools.
Heart attack: chest pain that spreads to your neck, shoulders and down the left arm.
Stroke: muscle weakness, numbness, altered sense of smell, taste, hearing and vision and confusion.
Meningitis: fever, vomiting, nausea, stiff neck, headache, sensitivity to bright light and confusion. This is more likely to occur in people with autoimmune diseases.
Other symptoms include: heartburn, indigestion, constipation, stomach ache, feeling sick or being sick, gaseous bowels, anaemia, changes to the numbers of white blood cells, high levels of blood potassium, insomnia, depression, confusion, hallucinations, headache, fits, feeling dizzy, light-headedness, sleepiness, pins and needles, numbness of your hands and feet, memory problems, loss of concentration, visual problems, eye pain, changes to your hearing, tinnitus, hearing loss, loss of balance, swelling of your hands, feet or legs, chest pains, tiredness, shortness of breath, palpitations, slow heartbeat, high blood pressure, problems with the way your heart pumps blood around the body, damage to your blood vessels, shortness of breath, feeling faint, general pain, difficulty breathing, wheezing, coughing, pneumonia, swelling of your lungs, bruising, itching, sweating, skin being more sensitive to the sun, hair loss, blood in the urine, kidney problems, excessive thirst, fever, feeling tired or generally unwell, sore mouth, mouth ulcers, muscle pain, weakness, infertility in women and systemic lupus erythematosus (SLE).
Can NSAIDs cause interactions with other medications?
Your doctor will need to be informed of any other treatment or supplements you are currently taking before being able to prescribe NSAIDs safely.
Naproxen may be unsuitable if you are taking any of the following: painkillers (such as aspirin), medicines that prevent blood clotting, diuretics, medicines that treat high blood pressure, a ‘cardiac glycoside’, steroids used to treat swelling and inflammation, probenecid, lithium, selective serotonin reuptake inhibitors (SSRIs), antidepressants, epilepsy medications, ACE inhibitors, sulfonamides, sulfonamide antibiotics, quinolone antibiotics (used to treat infections), sulfonylurea, angiotensin-II receptor antagonists, medicines used to prevent transplant rejection after surgery, methotrexate, cholestyramine, zidovudine and mifepristone.
Warnings and precautions when taking NSAIDs
You should make your prescribing clinician aware of any condition you currently have or are prone to before starting treatment with NSAIDs. Each NSAID may carry its own risks regarding any unrelated conditions you have, so it is also important to refer to the patient information leaflet if you have any concerns.
In the case of Naproxen, you should avoid using it if you have: allergies to naproxen or any of its ingredients, allergies to aspirin or any other NSAID, stomach ulcers, duodenal ulcers, serious liver or kidney disease and bleeding in the stomach or intestines during previous NSAID treatments.
Your prescribing clinician may recommend that you take an alternative form of medication if any of the following applies to you: if you have had or have heart problems, strokes, high blood pressure, diabetes, high cholesterol, are a smoker, have had or are having problems with blood clots, asthma, allergies, swelling of the face, lips, eyes or tongue, weakness, are elderly, have or have had lumps in the nose (polyps), sneeze a lot, rhinitis, have had or have problems with your blood vessels, localised swelling, high blood pressure, heart failure, have too much fat in your blood, problems with your kidneys or liver, autoimmune conditions, colitis or Crohn's disease.
Can NSAIDs impact on pregnancy, breastfeeding and fertility?
If you think you may be pregnant, are thinking of becoming pregnant, are pregnant or are breastfeeding, it’s essential that you inform your prescribing clinician before taking NSAIDs,as they may present a risk to the health of your baby. Some NSAIDs may also reduce the level of fertility in women, making it harder to become pregnant.
What types of NSAIDs are available?
NSAIDs are available in different forms, from tablets and capsules to creams and suppositories. They are also available over the counter in the form of aspirin (high dose aspirin is only available on prescription) or ibuprofen. Naproxen, diclofenac, celecoxib, mefenamic acid, indomethacin and etoricoxib are only available on prescription.
Is it safe to drive whilst taking NSAIDs?
Some side effects related to NSAIDs can inhibit your ability to drive. These include visual problems, dizziness, fatigue and balance. You should ensure that you are aware of any side effects these drugs produce before operating any heavy machinery.
Can NSAIDs cause any allergic reactions?
You should make your doctor aware of any allergies that you have before starting treatment with NSAIDs. The patient information leaflet that comes with your treatment will also provide a list of all your medication’s ingredients.
Some NSAID tablets contain lactose, which some people may have an intolerance of.
Can I buy NSAIDs over the counter?
Some NSAIDs are available to buy from your local pharmacy or convenience store over the counter, but stronger types, or NSAIDs with a higher risk of causing severe side effects or interactions with other drugs, require a prescription.
How can I buy NSAIDs online?
You can discuss NSAIDs and any related conditions with one of our GPhC-registered clinicians using our online video consultation service. You can book an appointment with them between 9.30am-4.30pm, Monday to Friday. Our clinicians can also issue fit notes and referrals to specialists for treatment, where suitable.