Nonsteroidal anti-inflammatory drugs are a drug class that groups together drugs that reduce pain, decrease fever, and, in higher doses, decrease inflammation. Side effects include an increased risk of stomach ulcers and heart attacks.
For most patients with RA, non-steroidal anti-inflammatory drugs (NSAIDs) are key tools in a comprehensive overall disease management strategy. NSAIDs are among the several classes of drugs that are commonly used to treat symptoms associated with RA, including pain, swelling, stiffness, and minor inflammation.
It is important to keep in mind that NSAIDs have no effect on the long-term damage to joints that can result from chronic inflammation associated with RA. Therefore, NSAIDs are considered an important adjunct (a term used for a therapy that is used in a supportive role) to disease-modifying treatments such as disease-modifying anti-rheumatic drugs DMARDs). Ideally, NSAIDs should be used to provide relief of acute pain and other symptoms and serve as a “bridge” therapy until a DMARD treatment takes full effect.
NSAIDs include over-the-counter medications ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin, and prescription medications celecoxib (Celebrex), piroxicam (Feldene) and indomethacin (Indocin). These NSAIDs are designed to provide fast relief of RA symptoms. To achieve its full anti-inflammatory effect, an NSAID must be taken continuously (at a specified dose) for a couple of weeks.1
Painkillers alone aren’t enough to treat rheumatoid arthritis, but they’re useful for topping up the pain-relieving effects of other, more specific drugs. Paracetamol is most often used. You may take it by itself, alongside other tablets or as a compound analgesic (e.g. co-codamol) in which it’s added to codeine. Stronger painkillers such as tramadol are also available.
A common side-effect of painkillers that contain codeine is constipation, which can occasionally be severe.
NSAIDs reduce pain and swelling, and they start working within a few hours. The effect of some will only last a few hours but others are effective all day. Your doctor will help you to find the preparation and dose that are right for you. About 20 different NSAIDs are available including ibuprofen, diclofenac and naproxen.
NSAIDs are usually taken as tablets or capsules and you should take them with a glass of water, with or shortly after food. You can also get NSAID creams and gels that can be applied directly to the painful area, or pessaries which are inserted into the back passage.
Like all drugs, NSAIDs can sometimes have side-effects. Your doctor may prescribe a proton pump inhibitor (PPI) alongside the NSAID, which will help to protect your stomach, and will try to keep the NSAID as low as possible while still controlling your symptoms. NSAIDS also carry a small incresed risk of heart attacks and strokes, so your doctor will be cautious about prescribing NSAIDs if you smoke, have diabetes, or if you have high blood pressure or high cholesterol.
Rheumatoid arthritis is a chronic disorder for which there is no known cure. Fortunately in the last few years, a shift in strategy toward the earlier institution of disease modifying drugs and the availability of new classes of medications have greatly improved the outcomes that can be expected by most patients. The goal of rheumatoid arthritis treatment now aims toward achieving the lowest possible level of arthritis disease activity and remission if possible, minimizing joint damage, and enhancing physical function and quality of life. The optimal treatment of RA requires a comprehensive program that combines medical, social, and emotional support for the patient. It is essential that the patient and the patient’s family be educated about the nature and course of the disease. Treatment options include medications, reduction of joint stress, physical and occupational therapy, and surgical intervention.
The hallmark symptoms of rheumatoid arthritis (RA), including sore and swollen joints, can leave you reaching for nonsteroidal anti-inflammatory drugs ( NSAIDs) such as aspirin and ibuprofen to help relieve discomfort. It’s important to realize, however, that just because these medications are available over the counter doesn’t mean they’re completely harmless — or that they’re the right choice for everyone with RA.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain and inflammation from arthritis and related conditions. They work by blocking hormone-like substances called prostaglandins, which are involved in pain and inflammation. Traditional NSAIDs block prostaglandins by inhibiting two enzymes, cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2).
By doing so, they leave the stomach vulnerable to ulcers and bleeding. Celecoxib (Celebrex) blocks only the COX-2, enzyme. It is less likely to damage the stomach.
Every NSAID may increase the risk of serious blood clots, heart attacks and stroke, which can increase with higher doses and long-term use. Although all NSAIDs work similarly to ease pain and inflammation, finding the most appropriate one for you may take some trial and error.
The dangers of NSAIDs are well-known yet often ignored, but now new research is making NSAID use even more questionable. What are NSAIDs? NSAIDs, aka nonsteroidal anti-inflammatory drugs, are one of the most commonly used pain relievers in the world today. In fact, most painkillers on the market today are NSAIDs.
They might effectively and temporarily decrease pain, but according to analysis of almost 10 million patient medical records, that dangers of NSAIDs are pretty clear. For instance, they may raise the risk of heart failure by nearly 20 percent. That risk increases with the amount of NSAIDs a person takes, says study author Andrea Arfe, a Ph.D student at the University of Milano-Bicocca, in Italy. Even though study findings are based on prescription NSAIDs, the results might apply to over-the-counter NSAIDs as well. Arfe notes: “Although over-the-counter NSAIDs are typically used at lower doses and for shorter durations, they are sometimes available at the same doses as prescription NSAIDs and they may be inappropriately overused.” (1)
Are you or someone important to you suffering from pain caused by rheumatoid arthritis, back pain, headaches, or a physical injury? Chronic pain can be very crippling, and it's natural for anyone to seek ways to relieve it. Millions of Americans who suffer from chronic pain take painkillers and believe it to be one of the primary methods for pain relief.
Today, 60 million Americans rely on a class of painkillers called non-steroidal anti-inflammatory drugs or NSAIDs, unaware that these medications can actually cause more harm than good.
Numerous studies link NSAIDs to detrimental side effects. Each year, over 100,000 people given an NSAID prescription are hospitalized, and about 15,000 succumb to death.
In 2000, Vioxx, a potent non-steroidal anti-inflammatory drug, was released in the market. A year before Vioxx was approved, I already warned the public about the cardiovascular risks associated with the drug. It took four years and 60,000 deaths (due to heart-related side effects) before warnings were heeded and Vioxx was removed from the market.
But it didn't stop there. In 2004, the US Food and Drug Administration (FDA) cautioned the public that NSAIDs, such as Cox-2 inhibitors Bextra (which was removed from the market in 2005) and Celebrex, along with other over-the-counter varieties like Aleve, Ibuprofen, and aspirin, all potentially lead to cardiovascular problems, GI bleeding, kidney problems, and increased blood pressure.
Pregnant women were especially warned against using NSAIDs. A study reported that prescription and OTC non-aspirin NSAIDs, such as diclofenac, naproxen (Aleve), celecoxib (Celebrex), and ibuprofen (Advil), increased their risk of miscarriage. These drugs suppress the production of prostaglandins that are needed for successful implantation of the embryo in the womb.
Other pregnancy-related side effects linked to NSAIDs include heart problems in the offspring, low amniotic fluid, and prolonged labor.
By Dr. Mercola
Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed extensively throughout the world. In the U.S., nearly 70 million prescriptions are written and 30 billion doses are consumed each year when over-the-counter NSAIDs are included.1
In many cases NSAIDs are prescribed to treat back pain, headaches, menstrual pain and arthritis. While most consider the medication innocuous, the truth is that by conservative estimates over 105,000 people are hospitalized each year from the side effects of NSAIDs and over 16,000 of those die.2
Side effects from long-term use of NSAIDs range from hearing loss to gastrointestinal bleeding. Unfortunately, there is no specific antidote for NSAID poisoning, which may lead to metabolic acidosis, multisystem organ failure and death.3
Research has now discovered side effects from NSAIDs may occur even with short-term use, increasing your risk of a heart attack in the first week to month if you take the medication consistently.4 The U.S. Food and Drug Administration (FDA) has recognized the risks associated with NSAIDs since 2004.5
In order to review all studies involving NSAIDs, the FDA also recommended limiting use of over-the-counter NSAIDs. This review order came on the heels of rofecoxib's (Vioxx) withdrawal from the market due to an increase in cardiovascular risk.6 Shortly after the withdrawal of Vioxx, another NSAID, valdecoxib (Bextra), was pulled from the shelves due to increased risk of heart, stomach and skin problems that outweighed the benefits of using the drug.7
By Dr. Mercola
Non-steroidal anti-inflammatory drugs or NSAIDs are among the most widely used pain killers in the world. In the United States, more than 70 million prescriptions for NSAIDs are written each year.
If you include over-the-counter (OTC) NSAIDs such as ibuprofen and aspirin, more than 30 billion doses of NSAIDs are used annually1 to relieve pain associated with everything from backaches and headaches to menstrual and rheumatoid arthritis pain.
NSAIDs work primarily by inhibiting your body's ability to synthesize prostaglandins, which are hormone-like chemicals made in response to cell injury. Unfortunately, many are completely unaware that these medications can actually cause very serious harm.
Stomach upset, nausea, and vomiting are among the most common side effects, but numerous studies have linked NSAIDs to far more adverse effects, including death.2 According to a 1998 study published in the American Journal of Medicine:3
"Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for non-steroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures of all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated."
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