Last Updated on May 6, 2023

Over-the-counter (OTC) anti-inflammatory drugs are commonly used to relieve pain, inflammation, swelling, and other symptoms associated with a variety of conditions. These drugs are widely available without a prescription and come in many different forms, including tablets, capsules, and creams.

While OTC anti-inflammatory meds can be effective for relieving pain and inflammation, they can also have potential side effects and interactions with other medications.

In this article, we will explore the different types of OTC anti-inflammatory drugs, their side effects, and other important information to help you make informed decisions about their use.

What Are NSAIDs?

NSAIDs stand for nonsteroidal anti-inflammatory drugs. These are a type of medication that is commonly used to relieve pain, fever, swelling, and inflammation. They can be used for both acute inflammation and chronic inflammation.

How Do NSAIDs Work?

NSAIDs work by blocking the activity of an enzyme called cyclooxygenase (COX), which is involved in the production of prostaglandins. Prostaglandins are chemical messengers that are produced in response to an injury or inflammation. By inhibiting COX, NSAIDs reduce the production of prostaglandins, thereby reducing pain, fever, and inflammation.

There are two types of COX enzymes: COX-1 and COX-2.

  • COX-1 is involved in the production of prostaglandins that protect the stomach lining and support kidney function, among other functions.
  • COX-2 is induced in response to inflammation and produces prostaglandins that contribute to pain and inflammation.

Some NSAIDs, such as aspirin, inhibit both COX-1 and COX-2, while others, such as ibuprofen and naproxen, primarily inhibit COX-2. This is why some NSAIDs are more effective at reducing pain and inflammation, while others have a higher risk of causing side effects such as stomach ulcers and bleeding.

NSAIDs vs Acetaminophen

NSAIDs and acetaminophen are both types of pain relievers, but they work in different ways and have different effects on the body.

  • NSAIDs work by inhibiting cyclooxygenase (COX), which contributes to the production of prostaglandins, which are known to cause pain and inflammation.
  • Acetaminophen works by blocking the production of certain chemicals in the brain that signal pain and fever. It is not an anti-inflammatory medication and does not have a direct effect on inflammation and swelling.

NSAIDs are generally more effective than acetaminophen in relieving pain and inflammation and reducing swelling, especially in conditions such as arthritis. However, NSAIDs can have more potential side effects, especially when used long-term or in high doses.

Uses for Anti-inflammatories

There are many causes of inflammation that NSAIDs can treat. Anti-inflammatory medications are commonly used to relieve pain, fever, and other signs of inflammation associated with a variety of conditions, such as:

  • Arthritis: Both osteoarthritis and rheumatoid arthritis involve inflammation and pain in the joints, making anti-inflammatory medications an important component of treatment.
  • Menstrual cramps: Anti-inflammatory medications can help to alleviate the pain and inflammation associated with menstrual cramps.
  • Headaches and migraines: Some types of headaches and migraines involve inflammation, and anti-inflammatory meds can help to reduce pain and discomfort.
  • Back pain: Inflammation can contribute to back pain, and anti-inflammatory drugs can help to relieve this pain.
  • Muscle sprains and strains: NSAIDs can help to reduce pain and inflammation associated with muscle sprains and strains.
  • Dental pain: Anti-inflammatory medications can help to lower pain and inflammation associated with dental procedures or conditions.
  • Post-operative pain: Anti-inflammatory drugs can help to manage pain and inflammation following surgery.
  • Fever: NSAIDs can help to reduce fever by decreasing the production of prostaglandins, which are involved in the regulation of body temperature.
  • Inflammatory bowel disease: Anti-inflammatory drugs can also help to reduce inflammation in the digestive tract, which is a key feature of IBD.

Types of Anti-inflammatories

There are several types of anti-inflammatory medications to choose from in the prescription and over-the-counter varieties that can assist with acute and chronic inflammation.

Over-the-Counter Anti-inflammatories

Over-the-counter anti-inflammatory drugs are medications that can be purchased without a prescription and are used to reduce pain, fever, swelling, and inflammation. Here are the most common examples of OTC anti-inflammatories.

  • Ibuprofen: Advil, Motrin, Nuprin
  • Aspirin: Bayer, Bufferin, Excedrin (also contains acetaminophen), Ecotrin, Anacin
  • Naproxen: Aleve, Naprosyn, Anaprox, Mediproxen

Prescription Anti-inflammatories

Prescription anti-inflammatory medications are medications that require a prescription from a healthcare provider. These prescription NSAIDs are more potent and help to manage a variety of serious conditions, such as rheumatoid arthritis, psoriatic arthritis, gout, and other forms of inflammatory arthritis.

  • Celecoxib (Celebrex)
  • Diclofenac (Voltaren)
  • Etodolac (Lodine)
  • Fenoprofen (Nalfon)
  • Flurbiprofen (Ansaid)
  • Indomethacin (Indocin)
  • Ketoprofen (Orudis)
  • Meloxicam (Mobic)
  • Nabumetone (Relafen)
  • Naproxen (Naprosyn)
  • Piroxicam (Feldene)
  • Sulindac (Clinoril)
  • Tolmetin (Tolectin)

It is crucial to use these medications responsibly and follow their instructions, and speak with a healthcare provider before starting any new medication or treatment regimen.

Side Effects of Anti-inflammatories

The side effects of anti-inflammatory drugs can vary depending on the specific medication, dosage, and individual patient factors. Some patients may experience side effects that are not listed here.

Additionally, certain populations, such as older adults or individuals with pre-existing medical conditions, may be more susceptible to side effects from anti-inflammatory medications.

Stomach Problems

Anti-inflammatory drugs can lead to stomach problems by interfering with the production of certain substances in the body that help protect the stomach lining.

By blocking COX, NSAIDs can decrease the production of protective prostaglandins and increase the production of stomach acid, which can lead to irritation, inflammation, and damage to the stomach lining.

Some of the types of stomach problems that NSAIDs can cause include:

  • Stomach pain or discomfort
  • Heartburn or indigestion
  • Nausea or vomiting
  • Loss of appetite
  • Ulcers or bleeding in the stomach or intestine
  • Perforation (a hole or tear) in the stomach or intestine

Heart Complications

Anti-inflammatory meds can lead to heart problems by restricting the production of certain substances in the body that help regulate blood flow and blood clotting.

By blocking COX, NSAIDs can diminish the beneficial activity of prostaglandins and increase the risk of blood clots, which can lead to a variety of heart problems.

Some of the types of heart problems that NSAIDs can cause include:

  • Increased risk of heart attack or stroke, particularly in individuals with pre-existing cardiovascular disease or risk factors
  • Increased risk of heart failure, especially in individuals with pre-existing heart failure or risk factors
  • Increased risk of high blood pressure, particularly with long-term use or at high doses
  • Increased risk of blood clots or abnormal bleeding, especially in individuals taking blood thinners or in high doses

Other Side Effects

Here are some common side effects of NSAIDs that are not related to the gastrointestinal or cardiovascular systems:

  • Kidney damage: NSAIDs can cause kidney damage or worsen pre-existing kidney conditions. Symptoms of kidney damage may include changes in urine color or amount, swelling in the feet or ankles, and fatigue.
  • Skin reactions: NSAIDs can cause skin reactions such as rashes, itching, and blisters. These reactions can be mild or severe and may be accompanied by fever and difficulty breathing.
  • Liver damage: Rarely, NSAIDs can cause liver damage, especially if taken in high doses or for long periods. Symptoms of liver damage may include jaundice, abdominal pain, and nausea.
  • Headaches: In some cases, NSAIDs can cause headaches or make existing headaches worse. This is known as a “rebound” headache and can occur when a person takes NSAIDs too frequently or in high doses.
  • Dizziness: NSAIDs can cause dizziness or lightheadedness, especially in older adults or those with existing medical conditions. This may increase the risk of falls and other accidents.
  • Allergic reactions: Rarely, NSAIDs can cause severe allergic reactions such as anaphylaxis, which can be life-threatening. Symptoms may include hives, difficulty breathing, and swelling of the face or throat.

When to Seek Medical Attention

If you are taking NSAIDs or other anti-inflammatory medications, you should seek medical attention if you experience any concerning symptoms or side effects, such as:

  • Severe stomach pain or discomfort
  • Bloody or black stools
  • Vomiting blood or material that looks like coffee grounds
  • Chest pain, shortness of breath, or other signs of heart attack or stroke
  • Rapid or irregular heartbeat
  • Swelling in the legs or feet
  • Unusual bruising or bleeding
  • Jaundice (yellowing of the skin or eyes)
  • Severe headache or dizziness
  • Hives, itching, and rash
  • Ringing in your ears
  • Blurred or distorted vision

These symptoms could be signs of a serious medical problem or an adverse reaction to the medication, and it is important to seek prompt medical attention if you experience any of these symptoms.

Drug Interactions

NSAIDs can interact with a variety of medications, and it is important to speak with a healthcare provider before taking NSAIDs if you are also taking any other medications. Some of the medications that can interact with NSAIDs include:

  • Warfarin and other blood thinners can increase the risk of bleeding when taken with NSAIDs
  • Cyclosporine and other immunosuppressant drugs can increase the risk of kidney damage when taken with NSAIDs
  • Lithium and other drugs used to treat mental health conditions can increase the risk of lithium toxicity when taken with NSAIDs
  • Low-dose aspirin can decrease the effectiveness of some NSAIDs and increase the risk of bleeding when taken with others
  • Selective serotonin reuptake inhibitors (SSRIs) and other drugs used to treat depression or anxiety, which can increase the risk of bleeding when taken with NSAIDs
  • Diuretics and other drugs used to treat high blood pressure or heart failure, which can decrease the effectiveness of some NSAIDs and increase the risk of kidney problems when taken with others

Additionally, other medications, including some over-the-counter drugs and herbal supplements, can also interact with NSAIDs.

Who Should Not Take NSAIDs?

While NSAIDs can be effective in reducing pain and inflammation in many individuals, certain groups of people should avoid taking these medications or use them only under the close supervision of a healthcare provider.

Some examples of individuals who may not be able to take NSAIDs or who may need to use them with caution include:

  • Those with a history of stomach ulcers or bleeding in the stomach or intestines
  • Individuals with kidney disease or reduced kidney function
  • If you have liver disease or reduced liver function
  • Those with heart disease or a history of heart attack or stroke
  • People with high blood pressure or fluid retention
  • Individuals with asthma or other respiratory problems
  • If you’re taking blood thinners or other medications that increase the risk of bleeding
  • Pregnant women, particularly in the third trimester

Can Children Take NSAIDs?

NSAIDs can be used to treat pain and fever in children, but it is important to use these medications safely and appropriately in pediatric patients. In general, the use of NSAIDs in children is considered safe and effective when used at appropriate doses and for appropriate durations. However, it is important to use these medications under the guidance of a healthcare provider and to follow all medication instructions and dosages carefully.

Some considerations for the use of NSAIDs in children include:

  • Using appropriate dosages for the child’s age and weight, as recommended by a healthcare provider or the medication label
  • Using the medication for the shortest possible duration needed to achieve symptom relief
  • Avoiding the use of multiple medications that contain NSAIDs, as this can increase the risk of side effects
  • Monitoring the child for side effects, such as stomach upset, headaches, or rash
  • Avoiding the use of NSAIDs in children with certain medical conditions or who are taking certain other medications

It is important to speak with a healthcare provider before giving NSAIDs to children, particularly children under the age of 2 years.

Reye’s Syndrome

Giving aspirin to children who have a viral infection, such as influenza or chickenpox, can increase the risk of Reye’s syndrome. Reye’s syndrome is a rare but serious condition that can cause liver and brain damage and can even be fatal. While the exact cause of Reye’s syndrome is not fully understood, it is believed to be related to the use of aspirin in children who have certain viral infections.

Giving aspirin to children who have a viral infection can lead to the accumulation of fatty acids in the liver and other organs, which can lead to liver and brain damage. Children who have a viral infection should be treated with other medications to control fever and pain, such as acetaminophen or ibuprofen, which are not associated with an increased risk of Reye’s syndrome.

Aspirin should be avoided in children unless specifically recommended by a healthcare provider for a specific medical condition.

Tips for Using OTC Anti-inflammatories

Here are some tips for using over-the-counter NSAIDs safely and effectively:

  • Read the label: Carefully read the medication label and follow all dosage and usage instructions. If you have any questions or concerns about the medication, ask a healthcare provider or pharmacist.
  • Take with food: Taking NSAIDs with food or milk can help reduce the risk of stomach upset or irritation. Avoid taking NSAIDs on an empty stomach.
  • Don’t mix medications: Avoid taking multiple medications that contain NSAIDs, as this can increase the risk of side effects.
  • Don’t exceed the recommended dosage: Stick to the recommended dosage and do not exceed the maximum daily dose listed on the medication label.
  • Use for the shortest duration possible: Use NSAIDs for the shortest possible duration needed to achieve symptom relief. If your symptoms persist, seek medical attention.
  • Monitor for side effects: Be aware of potential side effects of NSAIDs, such as stomach upset, headaches, or rash. Seek medical attention if you experience any concerning symptoms or side effects.

Alternatives to NSAIDs

There are several alternatives to using NSAIDs for pain and inflammation relief. Here are some examples:

  • Acetaminophen: Acetaminophen is a pain reliever and fever reducer that is a good alternative to NSAIDs for people who cannot take or do not want to take NSAIDs. Acetaminophen works differently than NSAIDs and is generally considered safe and effective when used as directed.
  • Physical therapy: Physical therapy can be an effective alternative to medication for certain types of pain and inflammation, particularly those related to muscle or joint injuries. Physical therapy can help improve strength, flexibility, and range of motion, and may help reduce pain and inflammation over time.
  • Massage therapy: Massage therapy is one of the best natural remedies for muscle pain and inflammation, particularly in areas that are prone to pain or stiffness.
  • Ice or heat therapy: Applying ice or heat to the affected area can help reduce inflammation and provide natural pain relief. Ice is particularly effective for acute injuries or pain, while heat can be more effective for chronic pain or stiffness.

How to Reduce Inflammation Naturally

If you want to learn how to reduce inflammation through natural means, try a combination of dietary and lifestyle changes. Here are some strategies for reducing inflammation naturally:

  • Limit inflammatory foods: Reduce or eliminate foods that cause inflammation, such as processed and fried foods, sugary drinks, and refined carbohydrates.
  • Eat anti-inflammatory foods: Start an anti-inflammatory diet that includes more foods such as fruits, vegetables, whole grains, and lean protein sources like fish and legumes.
  • Make lifestyle modifications: Exercise regularly, maintain a healthy weight, get enough sleep, and manage stress through relaxation techniques like yoga or meditation.
  • Take dietary supplements: Certain supplements as well as anti-inflammatory herbs and spices, like ginger, black pepper, and curcumin can help reduce inflammation.

By incorporating these natural strategies into your daily routine, you can help reduce inflammation and promote overall health and well-being. We also recommend the following proven natural anti-inflammatory supplements to get started with.

Turmeric is a spice that contains curcumin, a compound that provides anti-inflammatory effects. Curcumin works by inhibiting multiple inflammatory signaling pathways, which can help decrease inflammation.

Apple cider vinegar is a popular home remedy for inflammation that can be used for a variety of health concerns. It contains acetic acid, which has been suggested to have anti-inflammatory properties by reducing the production of certain inflammatory markers.

Elderberry is a fruit that has been shown to possess anti-inflammatory properties due to the presence of various bioactive compounds. The flavonoids, particularly anthocyanins, present in elderberry have been suggested to reduce inflammation by modulating the activity of several inflammatory signaling pathways.

OTC Anti-inflammatory Meds: Final Thoughts

Over-the-counter anti-inflammatory drugs can be a convenient and effective way to manage pain, inflammation, and swelling associated with a range of conditions. However, it is important to use these drugs responsibly as they can have potential side effects and interactions with other medications.

By understanding the different types of OTC anti-inflammatory medications, their side effects, and other important information, individuals can make informed decisions about their use and ensure they are getting the most benefit from these drugs while minimizing the risk of harm.

As always, it is important to speak with a healthcare provider before starting any new medication or treatment regimen.

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