NSAIDs, non-steroidal anti-inflammatory drugs,  is the group of medications that are used in the treatment of arthritis. They are divided into two groups, the COX-1 (traditional) and COX-2(coxibs) medications. The most commonly used traditional NSAIDs are ibuprofen (advil), meloxicam and naproxen. The example of coxib is celecoxib (celebrex).

NSAIDs should not be used in some situations:

• in patients with recent stomach or bowel ulcer.
• in patients with chronic kidney or liver diseases.
• in patients with congestive heart failure.
• in patients with recent heart attack or stroke.
• patients with asthma should avoid aspirin since it can be exacerbated.

NSAIDs should be used with caution in:

• patients who are over 65.
• patients with history of peptic ulcer.
• patients who are taking warfarin (coumadin).
• patients with risk factors for stroke or heart disease.

NSAIDs are safe for use in the first and second trimester of pregnancy and should be avoided in the third trimester.

NSAIDs are recommended to take with food or along with one of the so called PPI medications (pariet, tecta, losec) to protect stomach. Coxibs have lower risk of peptic ulcer disease.

Common side effects of NSAIDs:

• stomach pain, heartburn, nausea.

Less common side effects are:

• headache, dizziness, ringing in the ears.
• bruising/bleeding.
• peptic ulcer (black or bloody stools, indigestion, vomiting of blood or “coffee ground” material).
• fluid retention with ankle swelling.
• blood pressure elevation (should be monitored).

Your pharmacist will give you the full list of the side effects when you buy the medication. Please, advise your pharmacist about other medications you take.