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Facts About NSAIDs (Nonsteroidal Anti-inflammatory Drugs)

Part 1 of 2 - NSAIDs Are Among the Most Commonly Prescribed Arthritis Drugs


Updated June 20, 2014

NSAIDs (nonsteroidal anti-inflammatory drugs) combat arthritis by interfering with the inflammatory process. NSAIDs are a large group of drugs commonly used to treat arthritis because of their:

NSAID Categories

There are three types of NSAIDs:

  • salicylates (both acetylated, such as aspirin, and nonacetylated)
  • traditional NSAIDs
  • COX-2 selective inhibitors

NSAIDs commonly used for arthritis include:

  • Ansaid (generic name flurbiprofen)
  • Arthrotec (generic name diclofenac with misoprostol)
  • Aspirin (acetylsalicylic acid)
  • Cataflam (generic name diclofenac potassium)
  • Celebrex (generic name celecoxib)
  • Clinoril (generic name sulindac)
  • Daypro (generic name oxaprozin)
  • Disalcid (generic name salsalate)
  • Dolobid (generic name diflunisal)
  • Feldene (generic name piroxicam)
  • Ibuprofen (brand names include Motrin, Advil, Mediprin, Nuprin, Motrin IB)
  • Indocin (generic name indomethacin)
  • Ketoprofen (brands names include Orudis, Oruvail, Actron, Orudis KT)
  • Lodine (generic name etodolac)
  • Meclomen (generic name meclofenamate sodium)
  • Mobic (generic name meloxicam)
  • Nalfon (generic name fenoprofen)
  • Naproxen (brand names include Naprosyn, Aleve, Naprelan, Anaprox)
  • Ponstel (generic name mefanamic acid)
  • Relafen (generic name nabumetone)
  • Tolectin (generic name tolmetin sodium)
  • Trilisate (generic name choline magnesium trisalicylate)
  • Voltaren (generic name diclofenac sodium)

How NSAIDs Work

In simple terms, NSAIDs work by reducing inflammation. They do this by blocking a key enzyme of inflammation called cyclooxygenase, which converts arachidonic acid to prostaglandins and leukotrienes. Prostaglandins cause local inflammation. Therefore, by inhibiting cyclooxygenase, NSAIDs reduce inflammation.

A particular NSAID may work better for you than one you tried before -- or may not work at all. That's because of something referred to as pharmacokinetic differences -- the process by which a drug is absorbed, distributed, metabolized, and eliminated.

More on the Enzyme Cyclooxygenase

There are two forms of cyclooxygenase, known as COX-1 and COX-2. COX-1 is involved in maintaining healthy stomach and kidney tissue. COX-2 is the enzyme responsible for inflammation. Because traditional NSAIDs block both COX-1 and COX-2, they can have unwanted side effects, such as stomach irritation or decreased kidney function. That's why researchers developed NSAIDS that only block COX-2. These COX-2 selective inhibitors are the newest group of NSAIDs.

FDA Actions for All NSAIDs

In 2004, the manufacturer of the COX-2 selective inhibitor Vioxx voluntarily withdrew it from the market after studies showed long-term use could increase risk of heart attack and stroke. A subsequent review by the U.S. Food and Drug Administration led to the 2005 requirement that all non-aspirin NSAIDs carry a related warning. It is important to discuss these potential risks with your doctor. (The aftermath has left only one COX-2 inhibitor on the market -- Celebrex.)

Go on to Part 2 ----- Facts About NSAIDs ----->

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