Anti-inflammatory medicines (NSAIDs)
Key facts
- You can get anti-inflammatory medicines (NSAIDs) with a doctor’s prescription or buy them over-the-counter to relieve pain, inflammation and fever.
- NSAIDs can cause side effects such as stomach upsets and bleeding.
- You can reduce your chance of harm by taking NSAIDs for a short time and at the lowest dose that helps with your symptoms.
- There are many brand names for the same NSAID medicine, and many different NSAIDs available, so be careful not to take more than you need by mistake.
What are NSAIDs?
Non-steroidal anti-inflammatory drugs, also known as NSAIDs are medicines that are used to relieve pain and reduce inflammation (redness and swelling).
In Australia, you can buy low-dose NSAIDs over-the-counter in a supermarket or pharmacy. You can also get stronger versions of NSAIDs with a doctor’s prescription. NSAIDs are widely available.
NSAIDs usually come in tablets or capsules. NSAIDs are also used in creams, gels, injections, sprays and suppositories.
What are NSAIDs used for?
You can use NSAIDs to help treat symptoms caused by a range of conditions. NSAIDs can be used to:
- relieve pain (for example, headache, toothache, period cramps, muscle strains and sprains, pain after surgery)
- reduce inflammation
- reduce fever
- treat arthritis
- treat some autoimmune conditions
How do NSAIDs work?
NSAIDs help to reduce pain and inflammation by stopping injured cells from making chemicals called prostaglandins. These chemicals cause inflammation and swelling. NSAIDS do not rely on a steroid to reduce inflammation.
Using an NSAID medicine does not stop the underlying cause of pain or inflammation.
What medicines contain NSAIDs?
NSAIDs are used in many different medicines. Some examples of NSAIDs are:
There are NSAIDs in over-the-counter medicines used for:
- pain
- cold and flu
- arthritis creams
- teething gels
- complementary and alternative medicines such as:
- willow tree bark extract
- herbal arthritis pills
To find out if a medicine contains an NSAIDs you should carefully read the label. Your pharmacist or doctor will also be able to help.
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What are the side effects or harms of taking NSAIDs?
All medicines have side effects. Common side effects that can happen after taking NSAIDs are:
- nausea, heartburn and indigestion
- feeling dizzy or drowsy
- ringing in your ears
- fluid retention (oedema)
- high blood pressure (hypertension)
- dehydration (not having enough fluids in your body)
More serious but less common side effects include stomach bleeding and kidney problems.
NSAIDs (including aspirin) can also trigger asthma in some people. If you have asthma and need an NSAID for pain relief, talk to your doctor first.
NSAIDs have also been linked to a small increase in your chance of having a stroke or heart attack.
Is it safe for me to take NSAIDs?
You should not take NSAIDs if you:
- are allergic or hypersensitive to them
- are pregnant or planning a pregnancy
- have a kidney or liver condition
- have a gastrointestinal (gut) ulcer or bleeding
Don’t give aspirin to children aged under 12 years old unless advised by a doctor. In children, aspirin can cause a very rare condition known as Reye’s Syndrome, which can be life-threatening.
You are more likely to have side effects from taking an NSAID if you already have medical condition such as:
- gastro-oesophageal reflux disease (GORD)
- stomach ulcers
- stomach bleeding
- high blood pressure
- heart problems
- diabetes
- a kidney or liver condition
Other factors that increase your chance of having a side effect from an NSAID are:
- being older than 65 years
- being dehydrated
- already taking another medicine that contains an NSAID
- taking more than the recommended dose or take it for a long time
- being pregnant
The Society of Hospital Pharmacists of Australia recommends that older people should not use NSAIDs on a regular basis.
How can I lower my risk of side effects?
In general, your chance of side effects can be lowered if you only use NSAIDs:
- occasionally
- for a limited time
- at the lowest dose you need to control your pain (but within the dose range recommended by your doctor or pharmacist)
You can lower your chances of stomach upset by taking NSAIDs with food.
It’s important that you always follow the dosing instructions carefully. For children, you need to give the dose written on the bottle or packaging, according to your child’s weight.
Is it safe to take NSAIDs with other medicines
Taking certain medicines can increase your chance of experiencing side effects with NSAIDs. These medicines include:
- medicines for cardiovascular disease — including medicines for high blood pressure such as beta blockers, ACE inhibitors and angiotensin receptor blockers (ARBs)
- blood thinners — such as: aspirin, warfarin or rivaroxaban, dabigatran or apixaban
- alendronate — used to treat osteoporosis
- methotrexate
Accidental overdose of NSAIDs
You need to be careful not to take one NSAID for a headache and another NSAID for a medicine for a cold.
If you take an NSAID for a chronic (long-term) condition such as arthritis, ask your doctor or pharmacist before taking cold and flu medicines. You need to take care to avoid an accidental overdose.
If you’re unsure, ask your doctor or pharmacist.
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When should I see my doctors?
If you buy over-the-counter NSAIDs, follow the instructions closely and do not take more than the recommended dose. Do not continue taking them for more than the recommended time.
Talk to your doctor if you have questions about the benefits and risks of NSAIDs. For many people, the health benefits of treatment outweigh the known risks.
If you are buying over-the-counter NSAIDs, talk to your pharmacist or your doctor.
Do not give NSAIDs to your child for more than 2 days without seeing a doctor.
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 stool (poo), or very dark stool
- vomit containing dark coffee-coloured bits
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Are there any alternatives to taking anti-inflammatory medicines?
If your pain and inflammation are localised (in one place) you could try a topical treatment. Try rubbing an anti-inflammatory gel or cream into sore muscles or using an anti-inflammatory throat lozenge.
You can also use medicines containing paracetamol to manage symptoms of pain and fever.
Your doctor can prescribe medicines that work in different ways to help with chronic (long term) conditions like arthritis.
Resources and support
You can check whether a medicine you’re taking is an NSAID, or contains an NSAID, on the healthdirect medicine page.
Speak to your pharmacist for information about prescription and over-the-counter medicines containing NSAIDs.
The Royal Children’s Hospital provides information in languages other than English about pain relief for children.
You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.
Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: June 2024
