Non-steroidal anti-inflammatory drugs are commonly used to treat ongoing pain from conditions like arthritis, as well as short-term pain from injuries, headache, fever, dental problems, and more. There are both prescription-strength NSAIDs (such as Celebrex, Idocin, and Mobic) and over-the-counter varieties (such as aspirin, ibuprofen, and naproxen). Although the strength varies, all NSAIDs work by blocking the production of a chemical that contributes to inflammation and swelling.
While NSAIDs can be highly effective and relatively low-risk when used for short-term treatment, the risk of gastrointestinal bleeding, heart attack, and stroke increases in people who use higher dose NSAIDs on a regular basis.
So what can you do to reduce your risk of complications if you are using an NSAID for chronic pain and inflammation? Start by talking to your doctor about any risk factors you may already have that could be exacerbated by NSAIDs.
Medical Risk Factors to Discuss with Your Doctor
Tell your doctor if you have or have had:
· A heart attack
· A stroke
· Cardiac bypass surgery
· Stomach ulcers
· Gastroesophageal reflux disease (GERD)
· Liver or kidney damage
· Crohn’s disease or ulcerative colitis
Having one of these health issues does not necessarily mean that you cannot take any NSAIDs, but your doctor will likely want to limit your dosage or give you instructions specific to your condition.
You should also let your health care provider know if you are diabetic or have other high risk factors for cardiovascular disease. Your doctor may suggest changes to reduce your risk for developing heart disease, such as:
· Quitting smoking
· Exercising on a regular basis
· Eating a diet that is low in fat and cholesterol
· Reducing your stress
What to Avoid While Taking NSAIDs
Limit your alcohol consumption when taking NSAIDs, as the interaction of the medication and alcohol increases your risk for gastrointestinal bleeding. With some of the higher-strength NSAIDs, you should avoid alcohol altogether. Talk to your doctor if you have questions about the interactions between alcohol and your pain reliever drug.
Your risk of side effects may increase if you are taking an NSAID along with any of the following drugs:
· Lithium
· SSRIs
· Clozapine
· Ciclosporin
· Methotrexate
· Phenytoin
· Warfarin
· Sulphonylurea
· Certain diuretics
Go over all your current medications with your doctor before starting a new NSAID.
Tips for Safely Taking NSAIDs
Your risk for NSAID side effects increases the more frequently you take this type of medicine, so always take the lowest effective dose for the shortest time period required to treat your pain.
If you already have personal risk factors for gastrointestinal problems, your doctor may have you take another medication alongside your NSAID to mitigate the risk of damage. A proton-pump inhibitor may be used to reduce your risk of developing stomach ulcers, while a stomach acid blocker drug may be used to reduce your risk of damaging the lining of your gastrointestinal tract. You may also be able to use a topical NSAID—such as Voltaren gel—to lower your risk for gastrointestinal harm.
Be sure to talk to your doctor about the pros and cons of any NSAID you are considering taking, whether it is a prescription or over-the-counter drug. By knowing the potential risks, you will be better prepared to take an NSAID as safely as possible. For more information about anti-inflammatory drugs, visit our Inflammation Conditions Page.
