Over-the-counter (OTC) medications are those you can purchase without a doctor’s prescription. Nonsteroidal anti-inflammatories (NSAIDs) are drugs designed to reduce inflammation. Some of the more common OTC NSAIDs are aspirin, ibuprofen (Advil, Motrin, Nuprin), and naproxen (Aleve, Naprosyn).
In inflammation, a substance called prostaglandins sensitizes your nerve endings and enhances pain. NSAIDs work by blocking prostaglandins. Prostaglandins also play a role in controlling your body temperature, so NSAIDs can help bring down your fever.
In many cases, NSAIDs can relieve your headache, backache, and muscle aches. They can also help reduce the inflammation and stiffness caused by arthritis and other inflammatory conditions. They are helpful in easing menstrual aches and pains. Your doctor might suggest taking an NSAID following minor surgery or for sprains or other injuries. If you’re at risk of heart attack or stroke, your doctor may recommend daily low-dose aspirin to help lower your risk.
When taking an OTC NSAIDs, be sure to read and follow label directions because products vary in strength. Anti-inflammatories tend to work quickly and most people can take them without a problem. NSAIDs generally have fewer adverse effects than corticosteroids, which also help with inflammation. Corticosteroids can cause weight gain and weakness, and can lower resistance to infection.
Even though you can buy NSAIDs without a prescription, there are some potential side effects and risks. NSAIDs aren’t a good idea for everybody. Before taking these medications, check with your doctor if you:
- have had an allergic reaction to aspirin or another pain reliever
- have a blood disease or take blood thinning medication
- have had stomach bleeding, stomach ulcers (peptic ulcers), or intestinal problems
- have high blood pressure or heart disease
- have liver or kidney disease
- consume three or more alcoholic beverages a day
Children under age 18 who may have chickenpox or influenza should avoid aspirin and products containing aspirin. Aspirin can increase the risk of Reye’s syndrome, which may result in liver damage. Reye’s syndrome is potentially fatal.
Some of the most commonly reported side effects include stomach upset, diarrhea, and gas. You can minimize these side effects by taking your medication with food, milk, or antacids. Less often, NSAIDs may cause lightheadedness, problems with concentration, or mild headache.
Serious side effects that require immediate medical attention include:
- ringing in your ears
- blurry vision
- rash, hives, itching
- fluid retention
- blood in your urine or stools
- vomiting, blood in vomit
- severe stomach pain
- chest pain, rapid heartbeat
- yellowing of the skin and eyes (jaundice)
NSAIDs can interact with other medications and make them less effective. Two examples are blood pressure medications and low-dose aspirin when used as a blood thinner. NSAIDs can actually enhance the impact of warfarin (Coumadin), a medication used to prevent or treat blood clots. That combination can lead to excessive bleeding.
Other combinations can cause serious side effects, too. Cyclosporine is used to treat arthritis or ulcerative colitis. It is also prescribed for people who have had an organ transplant. Taking it with an NSAID can lead to liver and kidney damage. Combining NSAIDs with the mood-stabilizing drug lithium can lead to a dangerous build up of lithium in your body.
Taking NSAIDs with low-dose aspirin can increase the risk of developing stomach ulcers. Bleeding within the digestive system may also be a problem if you take NSAIDs with selective serotonin reuptake inhibitors (SSRIs).
It’s usually not a problem, but if you take diuretics and NSAIDs, you should be monitored for high blood pressure and kidney damage.
Some OTC medications, like acetaminophen (Tylenol) are good for relieving pain, but they don’t help with inflammation. If you can tolerate them, NSAIDs are probably the better choice for arthritis and other inflammatory conditions.
Some OTC products combine acetaminophen and anti-inflammatory medicine. NSAIDs can also be found in some cold and flu medications. Be sure to read the ingredients list on all OTC medications so you know exactly what you’re taking.
NSAIDs are intended for occasional and short-term use. The risk of side effects increases the longer you use them, so consult with your doctor.
OTC medications can lose their effectiveness before the expiration date if stored in a hot, humid place, like your bathroom medicine cabinet. Keep them in a cool, dry place.
Higher dose NSAIDs are available by prescription.