NSAID

NSAID stands for nonsteroidal anti-inflammatory drug — a class of medications that reduce pain, lower fever, and decrease inflammation. They are among the most widely used medications in the world, with common examples including ibuprofen (Advil, Motrin), naproxen (Aleve), aspirin, and celecoxib (Celebrex). NSAIDs work by inhibiting cyclooxygenase (COX) enzymes, which are responsible for producing prostaglandins — chemical messengers that promote inflammation, pain, and fever.

There are two main COX enzymes: COX-1 (which produces prostaglandins that protect the stomach lining and support kidney function and platelet aggregation) and COX-2 (which produces prostaglandins primarily involved in inflammation and pain). Traditional NSAIDs block both COX-1 and COX-2, which is why they can cause stomach irritation and bleeding as a side effect. Selective COX-2 inhibitors (like celecoxib) were developed to reduce inflammation with fewer gastrointestinal side effects, though they carry increased cardiovascular risk.

Despite their widespread availability — many NSAIDs are sold over-the-counter — they are not risk-free. Regular NSAID use can cause gastrointestinal ulcers and bleeding, kidney damage, cardiovascular events (heart attack, stroke), and elevated blood pressure. These risks increase with higher doses, longer duration of use, and in older adults or those with pre-existing conditions.

NSAIDs are first-line treatments for many pain and inflammatory conditions including headaches, menstrual cramps, arthritis, sports injuries, and post-surgical pain. If your doctor has recommended an NSAID, they've weighed its benefits against its risks for your specific situation. Taking NSAIDs with food, using the lowest effective dose for the shortest duration, and avoiding combination with other NSAIDs reduces risk.

If you have a history of stomach ulcers, kidney disease, heart disease, or are taking blood thinners, NSAIDs may not be appropriate. Alternative pain management options including acetaminophen (Tylenol), topical NSAIDs, physical therapy, and other targeted treatments may be safer in these situations.