Non-Steroidal Anti-Inflammatory Drugs

Non-steroidal anti-inflammatory drugs (NSAID) are by far one of the most commonly prescribed and used drugs. Their worldwide consumption can be counted in hundreds or even thousands of tones per year. In addition to their undeniable benefits, these drugs have many side effects, in some cases even life-threatening. Therefore, it is necessary to have more information about basic representatives of NSAID.


NSAID drugs include a variety of preparations that are able to block the function of an enzyme known as cyclooxygenase (COX). Cyclooxygenase is responsible for formation of substances that are necessary for successful inflammatory response, including increased body temperature and feeling of pain. Although these inflammatory reactions are absolutely natural defensive measures of our organism, we consider them uncomfortable and we want to dampen their symptoms. Suppression of symptoms of inflammation is the main goal of NSAID medicines. Therefore, these drugs do not cure; they “only” relieve the manifestation.


The specific effects of individual drugs are somewhat variable, but in general we can say that they reduce pain, suppress inflammation, decrease the elevated temperature and by negative affection of certain platelet functions they also reduce blood clotting.

Used substances

There are a number of active substances that are contained in hundreds of different preparations. I would like to mention the most commonly used substances – acetylsalicylic acid, diclofenac, ibuprofen, indomethacin, ketoprofen, meloxicam, metamizole, nimesulide and piroxicam.


Most drugs are used to relieve acute or chronic pain, they are effective painkillers. We can use them in orthopedic types of pain (acute gout, inflammation of tendons and joints, backache, rheumatic diseases, conditions after injuries, etc.), in headaches, migraine, menstrual abdominal discomfort and toothache. Some preparations are effective in reduction of fever and drugs containing the acetylsalicylic acid may be in small doses used to decrease blood clotting (i.e. a less strong form of anticoagulant drugs).


NSAID medications have a large number of side effects that usually occur, when the drugs are used chronically. Fairly typical are digestive problems including stomach inflammation, increased risk of bleeding into the digestive tract and development of peptic ulcers. The drugs can also damage kidneys and impair kidney functions, cause increase of liver tests, headaches and allergic reactions. Some drugs may cause non-infectious liver inflammation; others significantly increase the general risk of bleeding, when combined with other anticoagulants. For this reason, it is important to realize that these drugs should be used as little as possible and ideally only when recommended by the physician. Of course, this does not happen in reality.


Note: There is a widely used substance paracetamol. While exhibiting attributes similar to NSAID drugs, it has virtually no anti-inflammatory effect and therefore, it is not par of this group. Paracetamol is used in therapy of fever and pain with great results.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources