Drugs in this group are used to relieve pain, stiffness, and inflammation of painful conditions affecting the muscles, bones, and joints. NSAIDs are called "non-steroidal".
Many "non-steroidal" are currently available, and others are being investigated in the hope of finding new compounds with fewer side effects.

Why they are used

"Non-steroidal" are widely prescribed for the treatment of osteoarthritis, rheumatoid arthritis, and other rheumatic conditions. They do not alter the progress of these diseases, but reduce inflammation and thus relieve pain and swelling of joints.
The response to the various drugs in this group varies between individuals and the first drug chosen may not be effective. It is sometimes necessary for the doctor to prescribe a number of different "non-steroidal" before finding the one that best suits a particular individual.
Because "non-steroidal» do not change the progress of the disease, additional treatment may be required, particularly for rheumatoid arthritis.
"Non-steroidal» are also commonly prescribed to relieve back pain, headaches, gout, menstrual pain, mild pain following surgery, and pain from soft tissue injuries, such as sprains and strains.

How they work

Prostaglandins are chemicals released by the body at the site of injury. They are responsible for producing inflammation and pain following tissue damage and in immune reactions. "Non-steroidal" block the production of prostaglandins and thus reduce pain and inflammation.

How they affect you

"Non-steroidal" are usually effective in reducing joint pain and swelling. They are rapidly absorbed from the digestive system and most start to relieve symptoms within an hour. When used regularly for long-term treatment, they reduce stiffness and may restore or improve the function of a joint if this has been impaired.

Most "non-steroidal" are short-acting and need to be taken a few times a day in order to provide optimal relief from pain. Some need to be taken only twice daily. Others, such as piroxicam, are very slowly eliminated from the body and are effective when taken once a day.

Risks and special precautions

With a few exceptions, most "non-steroidal» are free from serious adverse effects although nausea, indigestion, and altered bowel action are common. Aspirin has a higher potential to irritate the stomach than that of most other "non-steroidal». However, the main risk from "non-steroidal" is that, occasionally, they can cause bleeding in the stomach or duodenum. They should therefore be avoided by people who suffer or have suffered from peptic ulcers.

Most "non-steroidal» are not recommended during pregnancy or for breast-feeding mothers. Caution is also advised for those with liver or kidney abnormalities or with a history of hypersensitivity to other drugs.
"Non-steroidal» may impair blood clotting and are, therefore, prescribed with caution for people with bleeding disorders or who are taking drugs that reduce blood clotting.

Misoprostol

An "non-steroidal"causes the side effect of bleeding when its antiprostaglandin action occurs where it is not wanted, such as in the digestive tract. To protect against this side effect, a prostaglandin-like drug called misoprostol is sometimes prescribed with the "non-steroidal". Formulations are now available that incorporate both misoprostol and an "non-steroidal». Misoprostol is also used to help heal peptic ulcers. As an alternative to giving drugs such as misoprostol, "non-steroidal" are being developed that work selectively by preventing prostaglandin production in the joints but not in the digestive tract. These drugs should lack the potential to cause bleeding and ulceration.

Action Of "Non-Steroidal" In Osteoarthritis
Non-steroidal anti-inflammatory drugs (NSAIDs) are often prescribed to diminish the pain and stiffness associated with osteoarthritis, a disorder in which, typically, a weight-bearing joint such as the hip is damaged by wear and tear or other factors.

Before treatment
The protective layers of cartilage surrounding the joint are worn away and the joint becomes inflamed and painful.

Effect of "Non-steroidal"
"Non-steroidal" reduce inflammation and may thus relieve pain, but damage to the joint remains and symptoms are likely to worsen or recur if the drug is stopped.

Common Drugs

Aceclofenac Acemetacin Aspirin * Azapropazone Benorylate Benzydamine Diclofenac * Diflunisal Etodolac Fenoprofen Flurbiprofen Felbinac

Ketoprofen * Mefenamic acid * Nabumetone Naproxen * Phenylbutazone Piroxicam * Sulindac Fenbufen * Tenoxicam Ibuprofen * Indomethacin * Tiaprofenic acid Tolmetin