Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There are many different pain medicines, and each one has advantages and risks. Some types of pain respond better to certain medicines than others. Each person may also have a slightly different response to a pain reliever.
Over-the-counter (OTC) medicines are good for many types of pain. There are two main types of OTC pain medicines: acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, naproxen (Aleve), and ibuprofen (Advil, Motrin) are examples of OTC NSAIDs.
If OTC medicines don’t relieve your pain, your doctor may prescribe something stronger. Many NSAIDs are also available at higher prescription doses. The most powerful pain relievers are opioids. They are very effective, but they can sometimes have serious side effects. There is also a risk of addiction. Because of the risks, you must use them only under a doctor’s supervision.
Nonsteroidal anti-inflammatory drugs — are among the most common pain relief medicines in the world. Every day more than 30 million Americans use them to soothe headaches, sprains, arthritissymptoms, and other daily discomforts, according to the American Gastroenterological Association.
And as if that wasn’t enough, in addition to dulling pain NSAIDs also lower fever and reduce swelling.
But how do those little pills do so much? And if they’re so good in some ways, why do they also raise the risk of heart problems in some people? The answer is complicated. Even researchers don’t fully understand how NSAIDs work.
Nonetheless, with the benefits and risks of NSAIDs in the headlines frequently, WebMD turned to four experts for a rundown of what researchers do know. Our panel consisted of:
- Byron Cryer, MD, a spokesman for the American Gastroenterological Association and an associate professor of medicine at the University of Texas Southwestern Medical Center in Dallas.
- Nieca Goldberg, MD, a spokeswoman for the American Heart Association and chief of Women’s Cardiac Care at Lennox Hill Hospital in New York.
- John Klippel, MD, president and CEO of the Arthritis Foundation in Atlanta.
- Scott Zashin, MD, clinical assistant professor at the University of Texas Southwestern Medical Center in Dallas and author of Arthritis Without Pain.
For what conditions are NSAIDs used?
NSAIDs are used primarily to treat inflammation, mild to moderate pain, and fever.
Specific uses include the treatment of:
Aspirin (also an NSAID) is used to inhibit the clotting of blood and prevent strokes and heart attacks in individuals at high risk for strokes and heart attacks.
NSAIDs also are included in many cold and allergy preparations.
Celecoxib (Celebrex) is used for treating familial adenomatous polyposis (FAP) to prevent the formation and growth of colon polyps.
The following list is an example of NSAIDs available:
- celecoxib (Celebrex)
- diclofenac (Cambia, Cataflam,Voltaren-XR, Zipsor, Zorvolex)
- diflunisal (Dolobid – discontinued brand)
- etodolac (Lodine – discontinued brand)
- ibuprofen (Motrin, Advil)
- indomethacin (Indocin)
- ketoprofen (Active-Ketoprofen [Orudis – discontinued brand])
- ketorolac (Toradol – discontinued brand)
- nabumetone (Relafen – discontinued brand)
- naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
- oxaprozin (Daypro)
- piroxicam (Feldene)
- salsalate (Disalsate [Amigesic – discontinued brand])
- sulindac (Clinoril – discontinued brand)
- tolmetin (Tolectin – discontinued brand)
Are there any differences between NSAIDs?
NSAIDs vary in their potency, duration of action, how they are eliminated from the body, how strongly they inhibit COX-1 versus COX-2 and their tendency to cause ulcers and promote bleeding. The more an NSAID blocks COX-1, the greater is its tendency to cause ulcers and promote bleeding. One NSAID, celecoxib (Celebrex), blocks COX-2 but has little effect on COX-1, and is therefore further classified as a selective COX-2 inhibitor. Selective COX-2 inhibitors cause less bleeding and fewer ulcers than other NSAIDs.
Aspirin is a unique NSAID, not only because of its many uses, but because it is the only NSAID that inhibits the clotting of blood for a prolonged period of time (4 to 7 days). This prolonged effect of aspirin makes it an ideal drug for preventing blood clots that cause heart attacks and strokes.
Most NSAIDs inhibit the clotting of blood for only a few hours. Ketorolac (Toradol) is a very potent NSAID and is used for moderately severe acute pain that usually requires narcotics. Ketorolac causes ulcers more frequently than other NSAID. Therefore, it is not used for more than five days. Although NSAIDs have a similar mechanism of action, individuals who do not respond to one NSAID may respond to another.
For more information about NSAIDs, please check following links: