NSAIDs can be used to relieve pain, reduce redness and swelling (inflammation), or treat a fever.

Examples include aspirin, naproxen, ibuprofen, celecoxib, diclofenac, meloxicam and COX-2 inhibitors.

What are NSAIDs used for?

NSAIDs can be used to relieve pain and symptoms associated with a range of conditions, including:

• headaches
• toothaches
• period cramps
• muscle strains and sprains
• arthritis
• back or neck pain
• some autoimmune conditions

In Australia, NSAIDs can be obtained on prescription and, for lower-dose forms, over-the-counter.

Almost every home would have some NSAIDs. They’re found in tablets, capsules, creams, liquids, injections, sprays and suppositories.

You can check whether a medicine you’re taking is an NSAID, or contains an NSAID, on our medicine page or the NPS MedicineWise website.

Side effects of NSAIDs

Do not take NSAIDs if you are allergic or hypersensitive to them, if you are pregnant or likely to become pregnant, or if you have a kidney or liver condition, or have a gastrointestinal ulcer or bleeding.

Common side effects of NSAIDs include nausea, heartburn and indigestion. The more serious, less common side effects include stomach bleeding or kidney problems. NSAIDs, including those bought over the counter, have also been linked to a small increase in risk of stroke and heart attack.

Anti-inflammatory medicines (including aspirin) can also trigger asthma in some people. If you have asthma and need an anti-inflammatory medicine for pain relief, talk to your doctor first.

Children under 16 years should not be given aspirin, unless advised by a doctor, due to the rare occurrence of Reye’s Syndrome, which is potentially fatal.

Who is at risk of side effects?

In general, the risk of side effects can be minimised if you take NSAIDs only occasionally and at the lowest dose needed to control your pain.

The risk of side effects increases if you:

• take certain medicines for cardiovascular disease (including high blood pressure medicines like beta blockers, ACE inhibitors and sartans), blood thinners like warfarin, the osteoporosis treatment alendronate or the rheumatoid arthritis treatment methotrexate
• have medical conditions such as gastro-oesophageal reflux disease (GORD), stomach ulcers, stomach bleeding, high blood pressure, heart problems, diabetes or a kidney or liver condition
• are older than 65
• are pregnant or likely to become pregnant (ask your doctor’s advice)
• are already taking another medicine that contains an NSAID
• drink alcohol
• take more than the recommended dose or take it for more than a few days at a time

Even if these things don’t apply to you, it’s important to follow the dose instructions carefully.

Stop taking NSAIDs and see your doctor if you notice anything wrong, especially any signs of stomach bleeding, such as:

• abdominal pain
• blood in your bowel motion (poo)
• dark coffee-coloured vomit

Talk to your health professional

Talk to your doctor about the benefits and risks of NSAIDs. For most people, the health benefits of treatment outweigh the known risks.

If you are thinking about buying over-the-counter NSAIDs, talk to your pharmacist or your doctor.

If you buy NSAIDs over the counter, follow the instructions closely and do not exceed the recommended dose or duration of treatment.

The Society of Hospital Pharmacists of Australia recommends that regular use of NSAIDS in older people is best avoided. For more information, visit the Choosing Wisely Australia website.