Adapted from The Faculty of Pain Medicine, Royal College of Anaesthetists, patient information booklet 2019. The original can be accessed at:https://fpm.ac.uk/sites/fpm/files/documents/2019-08/NSAID%202018Final.pdf
What are anti-inflammatory medicines?
• These can be called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). They include ibuprofen, naproxen, diclofenac, meloxicam, indomethacin, piroxicam, etoricoxib.
• The NSAID your prescriber has chosen for you will have a leaflet with detailed information about the specific medicine and its side effects.
• You can also ask your pharmacist or prescriber if you have any questions.
Why have I been prescribed a NSAID?
• NSAIDs are used to treat pain from an injury or surgery.
• NSAIDs can also be used in long term painful conditions, such as osteoarthritis, back pain, rheumatoid
arthritis.
• Taking NSAIDs may mean that you can reduce stronger pain medicines, which leads to fewer side effects.
This leaflet has been developed in conjunction with the British Pain Society, Pain UK and the Royal College of
Nursing, and has been endorsed by The Royal Pharmaceutical Society.
How do NSAIDs work?
• When you feel pain and stiffness, your body is making chemicals (prostaglandins) which ‘tell’ you it
hurts.
• NSAIDs reduce the amount of these prostaglandins and therefore reduces your pain but they may not
alter the progress of the disease.
When should I take it?
• NSAIDs can be taken regularly or as needed if the pain is not constant.
• NSAIDs should ideally be taken with or shortly after food.
How are NSAIDs taken?
• NSAIDs come in many different forms including tablets, capsules, or a liquid.
• Some come as a gel or cream to rub into the painful area.
• Some people prefer to take it by suppository.
• Do not take more than prescribed.
• Do not take more than one NSAID at a time as their effects can add up causing more side effects.
How long will it take to work?
• Everyone is different. The average time for pain to reduce is an hour after taking a tablet or
suppository, however it may take longer for the full effect.
• NSAIDs as a gel or cream can vary in the time it takes to give pain relief.
• NSAIDs do not work for everyone. If there is no improvement in your pain you should consult your
prescriber.
What are the possible side effects?
• Most side effects are mild.
• Common side effects include heartburn, indigestion or pains in your stomach, and feeling sick (nausea) or being sick (vomiting). If these side effects are frequent and severe, you should stop taking the medicine and consult your prescriber or pharmacist.
• If you vomit any blood or dark particles that look like coffee grounds or have blood stained faeces (stools/motions) : You should stop taking the medicine immediately and seek medical advice.
• Less common side effects include headache, dizziness, swollen feet or legs, and weight gain. Again if these side effects are constant and severe discuss with your prescriber or pharmacist. Other less common side effects include a rash or itching, or unexplained wheezing or shortness of breath. If you
have any of these side effects you should discuss them with your prescriber or pharmacist.
• Recent evidence suggests that even short term NSAID use may be linked to a very small increased risk of having a stroke or heart attack. However your risk of having a stroke or a heart attack whilst taking NSAIDs is thought to remain very low. The risk of this increases with dose and duration of treatment and the risk is greater for those who already have heart disease.
• Before taking a NSAID, your prescriber should discuss the risk of heart attack or stroke with you.
• If you experience chest pain, shortness of breath, or sudden weakness or difficulty speaking while taking a NSAID, seek medical help immediately.
• Use of NSAIDs, even for a short period of time, can harm the kidneys. This is especially true in people with underlying kidney disease.
• Side effects are usually related to the dose of medicine you take, but some people are more sensitive than others. They are less likely if you can take the smallest dose that you find reduces your pain.
Can I take this medicine long-term?
• NSAIDs can be taken for long term conditions. You should first discuss it with your prescriber to make sure it is safe.
• The benefit of long term NSAID use should be regularly reviewed with your prescriber.
Can I drink alcohol?
• Once you are settled on a stable dose, you may drink alcohol in moderation.
Can I drive?
• Yes, it is usually safe to drive whilst taking a NSAID.
• Although not common, NSAIDs may make you dizzy or drowsy. If you experience any of these symptoms do not drive, operate machinery or do anything, including driving that requires you to be alert.
• NSAID use is associated with a very small increased risk of motor vehicle accidents. It is not clear if this increased risk is a result of medicine related side effects, or the underlying pain condition, however NSAID information leaflets produced by manufacturers warn of caution when driving or using heavy machinery.
What should I tell my prescriber?
• If you are allergic to any medicines.
• If you are taking any other prescribed medicines, bought from the pharmacy or herbal medicines.
• If you are pregnant or breastfeeding, or if you are planning to become pregnant in the future.
• If you have:
- a stomach ulcer or have had one in the past
- a kidney problem
- asthma or any other breathing disorder
- any problem with bleeding or blood clots
- a liver problem
- Crohn’s Disease or ulcerative colitis
- high-blood pressure
- had a heart attack, suffer with angina or have recurrent chest pains
- shortness of breath, fatigue, swelling in legs, ankles or feet, or other symptoms of heart failure
- had a stroke
- dementia or Parkinson’s disease
What if I forget or miss a dose?
• Take it as soon as you remember, unless it is almost time for your next dose. If it is, skip the missed
dose and take your next dose as normal.
• Do not take two doses together.
• Ensure that you do not take more than the maximum prescribed daily dose.- What if I want to stop taking NSAIDs?
• Over time your pain may change. It is important to regularly review whether you still need to use your NSAID medicine.
• If your pain improves, you should consider stopping your medicine or reducing the dose as any medicine can have unwanted side effects.
• Although you can safely stop taking your NSAID whenever you want to. It is best to discuss it with your prescriber if you have been taking them for a long time.