Over-the-Counter Anti-inflammatory Drugs: Types, Side Effects, and More

Written by Resurchify | Updated on: March 02, 2023

Over-the-Counter Anti-inflammatory Drugs: Types, Side Effects, and More

Do you go to the pharmacist and ask him for medicines rather than consulting the doctor? Do you consume over the counter medicines without a doctor’s recommendation? Do you trust the pharmacist for over the counter medicines for your ailment and avoid visiting the doctor? While you may be saving some extra bucks, you may be risking your lives. We have compiled some helpful information you may need if you think of taking some over the counter anti-inflammatory drugs. We have combined the types of medicines, the side effects they bring, the risks involved with taking these medicines, how to be careful not to risk your life with the medication, their impact on children and babies and more. Read ahead before you think of taking an anti-inflammatory over the counter drug for your ailment.

Over the counter (OTC) medicines are drugs that require no doctor’s prescription to buy.  Nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce inflammation, which can help with pain relief. Some common Over the counter NSAIDs are:

  • Naproxen (Aleve, Naprosyn)
  • High dose aspirin
  • Ibuprofen (Advil, Motrin, Midol)

NSAIDs work quickly and are very effective. NSAIDs also have significantly fewer side effects than other anti-inflammatory drugs like corticosteroids.

Before using NSAIDs, it is best to know about the side effects and drug interactions. Read ahead to learn some crucial information about NSAIDs for safe and effective use.


Prostaglandins tend to sensitise the nerve endings, and that causes an increase in pain during inflammation. They also have a say in the body temperature. The NSAIDs block these prostaglandins.

NSAIDs help with pain and fever by hampering the effects of prostaglandins. NSAIDs can also help you with other problems like:

  • Muscle aches
  • Backache
  • Inflammation and stiffness
  • Menstrual aches and pains
  • Sprains and other injuries
  • Pain after a minor surgery
  • Headache

NSAIDs are significantly helpful in managing arthritis symptoms like inflammation, joint pain and stiffness. Usually, NSAIDs are the first medications given to an arthritis patient because of the easy accessibility and lower cost.

For longer terms, celecoxib (Celebrex), a prescription drug, is prescribed for arthritis symptoms management due to their easiness on your stomach than other NSAIDs.

Types of NSAIDs

NSAIDs help by blocking the cyclooxygenase (COX) enzyme so they can not produce prostaglandins. The human body produces two types of COX: COX-1 and COX-2. COX-1 guards your stomach lining while COX-2 tends to cause inflammation. The majority of NSAIDs are nonspecific, which is that they block both COX-1 and COX-2.

Nonspecific NSAIDs available over the counter in the United States are:

  • Naproxen (Aleve, Naprosyn)
  • High dose aspirin
  • Ibuprofen (Advil, Motrin, Midol)

Low dose aspirin is not considered an NSAID.

Nonspecific NSAIDs available in the United States with a prescription are:

  • Diclofenac (Zorvolex)
  • Diflunisal
  • Etodolac
  • Famotidine/ibuprofen (Duexis)
  • Flurbiprofen
  • Indomethacin (Tivorbex)
  • Ketoprofen
  • Mefenamic acid (Ponstel)
  • Meloxicam (Vivlodex, Mobic)
  • Nabumetone
  • Oxaprozin (Daypro)
  • Piroxicam (Feldene)
  • Sulindac

Drugs that block more COX-2 than COX-1 are known as selective COX-2 inhibitors. Currently, Celecoxib (Celebrex) is the only selective COX-2 inhibitor available in the United States on prescription.

Side Effects

Just because NSAIDs are available over the counter does not mean that they are harmless. NSAIDs bring side effects and risks, and the most common are an upset stomach, diarrhoea or gas. The longer you use NSAIDs, the riskier they become. They are tended for only short term use. Do not mix different NSAIDs, and always consult your physician before taking any NSAID.

Stomach Problems

COX-1 is responsible for your stomach lining, and NSAIDs tend to block them. Hence, they can lead to some minor gastrointestinal issues like:

  • Upset stomach
  • Diarrhoea
  • Heartburn
  • Constipation
  • Nausea and vomiting
  • Gas

Sometimes, NSAIDs can cause severe problems like irritating the stomach lining, which can lead to ulcers. Some ulcers can even cause internal bleeding. Call your doctor and stop using NSAIDs if you experience any of the following:

  • Blood in stool
  • Severe abdominal pain
  • Black or tarry stool

People who have the following habits are more likely to suffer from stomach issues due to NSAIDs.

  • Take blood thinners or corticosteroids
  • Have a history of stomach ulcers
  • Take NSAIDs frequently
  • People over the age of 65

If you take NSAIDs with milk, food or antacid, you will be less likely to develop stomach issues from NSAIDs. If you suffer from gastrointestinal issues due to NSAIDs, your doctor may recommend you to start taking selective COX-2 inhibitors like celecoxib (Celebrex). They have less probability of causing stomach issues than nonspecific NSAIDs.

Heart Complications

You are at a higher risk of developing the following heart issues by taking NSAIDs.

  • Stroke
  • Heart failure
  • Blood clots
  • Heart attack

Frequent use and higher dosages can increase the risk of heart complications. If you suffer from cardiovascular disease, you are at a higher risk of developing heart-related issues by consuming NSAIDs.

When to call your doctor?

If any of the following symptoms come up, stop taking NSAIDs and call your doctor.

  • Fluid retention
  • Rapid heart rate
  • Jaundice
  • Blurry vision
  • Ringing in the ears
  • Severe stomach pain
  • Vomiting and blood in the vomit
  • Blood in urine or stool
  • Rash, hives and itching
  • Chest pain

Drug interactions: NSAIDs can interact with other medicinal drugs. They decrease the effectiveness of some medicines on interaction. Blood pressure medication and low-dose aspirin (when used as a blood thinner) are two examples.

Other drug combinations cause side effects. Be cautious while taking the following drugs:

  • Warfarin: NSAIDs tend to enhance the effects of warfarin (Coumadin), a medicine for the prevention and treatment of blood clots. This combination can cause excessive bleeding.
  • Cyclosporine: Cyclosporine (Neoral, Sandimmune) is medicine for arthritis or ulcerative colitis (UC). People who had an organ transplant are also prescribed this medicine. But, if you take these with NSAIDs, it can cause kidney damage.
  • Lithium: Lithium is a mood stabilising drug and, when taken with NSAIDs, can cause a dangerous lithium buildup in the body.
  • Low dose aspirin: When combined, NSAIDs and low dose aspirin increase your risk of getting stomach ulcers.
  • Selective serotonin reuptake inhibitors (SSRIs): If you take Selective serotonin reuptake inhibitors (SSRIs) with NSAIDs, it can cause bleeding in your digestive system.
  • Diuretics: Diuretics and NSAIDs do not usually cause problems when taken together, But you should always keep your blood pressure in check and monitor your kidney for damages.

For children: Always consult your doctor before giving NSAIDs to a child below 2. There is a dosage chart included with the drugs based on the weight. Always check the chart before you give your child NSAIDs. The most common NSAID in children is Ibuprofen (Advil, Motrin, Midol). It is also the only approved NSAID for children as young as three months old. Another drug Naproxen (Aleve, Naprosyn), can be prescribed to children older than 12.

Aspirin has the approval for use for children older than 3. But, children below 17 suffering from flu or chickenpox should avoid it and the products containing aspirin. In children, aspirin can increase the risk of Reye’s syndrome, a severe condition causing swelling in the brain and liver.

Reye’s Syndrome

You can notice the early symptoms of Reye’s syndrome when you are recovering from a viral infection, like flu or chickenpox. But, you can also have  Reye’s syndrome 3-5 days after the infection starts. Children under 2 have initial symptoms like diarrhoea and rapid breathing. In comparison, older children and teenagers experience vomiting and unusual sleepiness.

Severe symptoms of  Reye’s syndrome are:

  • Aggressive or irrational behaviour
  • Seizures
  • Loss of consciousness
  • Confusion or hallucinations
  • Weakness or paralysis in legs and arms

Immediately consult your doctor if you reckon that your child may have  Reye’s syndrome. Early diagnosis and treatment can save lives.

Tips for using over the counter NSAIDs: The following tips can help you get the best results from an over the counter treatment.

  • Assess your needs: Some over the counter medicines, like acetaminophen (Tylenol), help relieve pain but do not cure inflammation. NSAIDs are a better cure for arthritis and other inflammatory diseases if tolerable.
  • Read the labels: In some over the counter products, a combination of acetaminophen and anti-inflammatory medicine is used. NSAIDs are an ingredient in some cold and flu medicines. Remember to read the over the counter medicines' labels to know how much you should consume and what you are taking. Too much of one ingredient in a combination increases the risk of side effects.
  • Store them properly: Store the over the counter medicine in a cool and dry place. They may become less effective even before the expiry date if stored in hot and humid conditions like a bathroom medicine cabinet.
  • Take the correct dose: The strength of over the counter NSAIDs varies with different products. Make sure to read and always follow the directions to take the right amount of medicine every time.

When to avoid NSAIDs?

NSAIDs are not always beneficial for everyone. Remember to consult with a medical professional before you take any medication and if you have or had the following:

  • High blood pressure or heart disease
  • A history of stroke or heart attack
  • Liver or kidney disease
  • A blood disease
  • An allergic reaction to aspirin or other pain relievers
  • Stomach bleeding, peptic ulcers or intestinal problems
  • Diabetes that is difficult to manage

If you are over 65, consult your medical advisor before taking NSAIDs. Also, ask your doctor before taking NSAIDs if you are pregnant. According to studies, taking NSAIDs early in pregnancy increases the risk of miscarriage. However, additional research is needed.

NSAIDs during the third trimester of pregnancy are not recommended. They can affect your baby by prematurely closing a blood vessel in their heart. If you are on blood-thinning medication or consume three or more alcoholic beverages in a day, you should consult your doctor before taking NSAIDs.

Anti-inflammatory drugs known as NSAIDs are available over-the-counter at lesser doses. People should use OTC anti-inflammatories with caution because they have the potential to cause harm to their health. For example, all NSAIDs can cause stomach bleeding, and ibuprofen and naproxen can increase the risk of heart attack and stroke.

Most people who take over-the-counter anti-inflammatories will have no harmful effects if they use them cautiously and always follow the dosing directions on the package. If a person is unsure about using NSAIDs, they should consult their physician.

Now, you know what to avoid and look out for in any of your ailments. NSAIDs can be a great pain reliever for pain caused by inflammation, and many are readily available over the counter. But always consult your doctor for the correct dosage and do not overconsume.

We made an effort to make yours a happy, healthy and safe life! Always read the label of your over-the-counter drugs, as NSAIDs can be an ingredient in many. Be careful with the medicines you take because they can have severe side effects and can even be risky for your life. Before consuming any drugs, always consult your doctor and be prepared for the side effects. Keep your health under check and call your doctor if you feel any adverse symptoms mentioned above.

Frequently Asked Questions (FAQs)

How do nonsteroidal anti-inflammatory drugs (NSAIDs) work?

NSAIDs work by inhibiting the generation of specific substances in the body that cause inflammation. Anti-inflammatory drugs (NSAIDs) effectively treat pain caused by gradual tissue deterioration, such as arthritic discomfort. NSAIDs are also effective in treating back pain, menstrual cramps, and headaches. NSAIDs act in the same way that corticosteroids (commonly known as steroids) do, but without the adverse side effects. Steroids are synthetic versions of cortisone, a naturally occurring hormone. NSAIDs help relieve pain and inflammation caused by joint and muscle disorders and accidents like cortisone.

How long should I take an over-the-counter nonsteroidal anti-inflammatory drug (NSAID)?

Unless your doctor says it's acceptable, don't use an over-the-counter NSAID for more than three days for fever and ten days for pain. Over-the-counter NSAIDs effectively relieve pain, but they're only designed to be used for a short period. If your doctor permits you to use NSAIDs for a lengthy time, keep looking for any potentially serious side effects with your doctor. If you have trouble with side effects, your treatment may need to be changed.

How long do nonsteroidal anti-inflammatory drugs (NSAIDs) take to work?

The time is dependent on the NSAID in question and the disease being treated. Some NSAIDs act quickly, while others take a week or two to work. We prescribe NSAIDs that work rapidly for acute (sharp, abrupt pain) muscle injuries. However, they may need to be taken every four to six hours because of their short action duration. Doctors commonly recommend NSAIDs for long-term osteoarthritis and rheumatoid arthritis therapy once or twice a day. On the other hand, these medications take longer to have a therapeutic (healing) impact.

How are nonsteroidal anti-inflammatory drugs (NSAIDs) prescribed?

Different doses of NSAIDs are administered based on the disease. You may take these medications one to four times each day. Do not raise your amount without first consulting your doctor. If you have rheumatoid arthritis (RA), higher doses of NSAIDs may be suggested. Heat, oedema, redness, and stiffness in the joints are all common symptoms of RA. Lower doses may be used for osteoarthritis and acute muscle injuries because there is minor oedema and typically no warmth or redness in the joints. There is no certainty that any NSAID will work. You and your doctor may need to test a variety of NSAIDs to discover the one that works best for you.

When should stronger NSAIDs be used?

Prescription-strength Rheumatologic illnesses, such as rheumatoid arthritis and moderate-to-severe osteoarthritis, are frequently treated with NSAIDs. These NSAIDs are also used for musculoskeletal problems that are moderately uncomfortable, such as back pain.

What are some of the most commonly prescribed nonsteroidal anti-inflammatory drugs (NSAIDs)?

A few instances of prescription NSAIDs are listed below. Some nonsteroidal anti-inflammatory drugs (NSAIDs) are only accessible in generic form (no brand names). Familiar brand names/generic names

  • Indomethacin or Indocin [available by brand name in liquid form])
  • Celecoxib (Celebrex)
  • Ketorolac tromethamine or Toradol
  • Fenoprofen (Nalfon)
  • Diclofenac or Voltaren [available by brand name in topical for]

Generic names (no brands)

  • Ketoprofen
  • Flurbiprofen
  • Meclofenamate sodium
  • Tolmetin
  • Diflunisal

How does my doctor decide which NSAID is best for me?

Your doctor considers the efficacy and dangers of these drugs when planning your treatment. Other medical conditions and your medical history, physical exam, X-rays, blood tests, and other medical conditions all influence which NSAIDs will work for you. Meet with your doctor frequently after you begin your NSAID program to check for any hazardous side effects and, if required, make any changes. This portion of your treatment may include blood tests or other diagnostics (including a kidney function test).

Are there any specific cautions for taking NSAIDs?

The Food and Drug Administration requires that NSAIDs be labelled with the following particular warnings: These are the non-aspirin NSAID warnings:

  • Your risk may increase if you have heart disease or risk factors for heart disease (such as high cholesterol, smoking, high blood pressure, or diabetes). However, people who do not have cardiac disease or those risk factors may have an increased risk. Non-aspirin NSAIDs have been linked to an increased heart attack and stroke risk. This danger can appear early in treatment and may worsen as time goes on.
  • Non-aspirin NSAIDs can induce heart difficulties in the first few weeks of usage, and they can happen more frequently with greater doses or long-term use.
  • You should not use Non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) before or after heart bypass surgery.

This warning applies to all nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin: NSAIDs have been linked to significant stomach and intestinal adverse effects such as ulcers and bleeding. These negative effects can appear suddenly and without notice. This risk is possibly higher in those who:

  • They are on multiple prescriptions or over-the-counter NSAIDs
  • They are in their later years.
  • Consume more than two alcoholic beverages in a day
  • Have a previous history of stomach ulcers or bleeding problems
  • They are on blood thinners.

What are the most prevalent NSAID adverse effects?

Take an NSAID over-the-counter with a prescription NSAID, several NSAIDs, or more than the recommended dose. If you take NSAIDs in excessive dosages or for a long time, you may experience adverse effects. You may experience more adverse consequences if you do so. Some side effects will go away, while others require medical treatment. The following are the most prevalent adverse effects; however, others may be. Call your doctor in case of any queries about your medication. NSAIDs are most commonly associated with gastrointestinal (stomach and gut) problems, such as:

  • Heartburn
  • Diarrhoea or constipation
  • Stomach pain
  • Vomiting
  • Gas
  • Nausea
  • Feeling bloated
  • You can avoid these gastrointestinal problems by taking medicine with food, milk, or antacids (such as Maalox or Mylanta). Call your doctor if you're taking the NSAID with food, milk, or an antacid if these symptoms last longer than a few days. The NSAID may need to be discontinued and replaced. Other NSAID side effects include:
    • Difficulty concentrating
    • Feeling lightheaded
    • Mild headaches
    • Dizziness
    • Problems with balance

Stop taking the NSAID and contact your doctor if these symptoms persist for more than a few days.

Can I use NSAIDs if I'm on blood pressure medication?

Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause high blood pressure (hypertension). If your blood pressure rises despite taking your blood pressure medication and eating a healthy diet, you may need to discontinue taking NSAIDs. Before you start taking NSAIDs, talk to your doctor about it.





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