NSAIDs are a family of medications that may be used for a variety of reasons, such as fever, pain and swelling. They are among the most widely used medicines, providing relief of such symptoms.
Many NSAIDs are inexpensive, effective over-the counter (OTC) medications. In rheumatology, NSAIDs are commonly used in patients that have arthritis, whether it is from rheumatoid arthritis, juvenile idiopathic arthritis (JIA), lupus or other diseases.
There are more than 15 different NSAIDs, including Naproxen (Naprosyn), Ibuprofen (like Motrin or Advil), Indomethacin (Indocin) and Celecoxib (Celebrex), among others.
With the exception of Ketorolac (Torodol), all NSAIDs are taken by mouth. With the exception of Celecoxib (Celebrex), the other NSAIDs mentioned above come in liquid forms, which may be desirable for young children.
The dosing frequency varies depending on the type of NSAID from once to four times daily.
NSAIDs may be sub-grouped into three groups: traditional NSAIDs, COX-2 inhibitors and salicylates.
NSAIDs provide symptomatic relief of arthritis mainly by blocking COX enzymes, which produce prostaglandin, and cause joint inflammation.
Importantly, prostaglandin also has other important roles in the body that include stomach protection and regulation of blood flow in the kidney.
Therefore, when these normal functions of prostaglandin, are blocked by traditional NSAIDs, one may experience side effects, such as stomach discomfort.
Traditional NSAIDs include the common over-the-counter medications such as ibuprofen (Advil), and block both COX-1 and COX-2 enzymes involved in making prostaglandin, which is partially responsible for the pain of arthritis.
COX-2 inhibitors, such as Celecoxib (Celebrex), only block the COX-2 enzyme of prostaglandin, and therefore have less GI side effects. COX-2 inhibitors have not been used as long as the traditional NSAIDs.
Rofecoxib (Vioxx) and Valdecoxib (Bextra) were withdrawn from the market in 2007 due to increased cardiovascular risk and serious skin reactions respectively.
The COX-2 inhibitors are also generally more expensive than traditional NSAIDs. Salicylates include medicines such as aspirin (like Anacin or Bayer). Although effective these medications may have more GI and bleeding side effects.
Overall, unlike many adults, children tend to tolerate NSAIDs with relatively few problems.
This does not include all of the possible side effects of NSAIDs
Call your doctor with any question.