NSAIDs: what they do and how to use them safely

NSAIDs (nonsteroidal anti-inflammatory drugs) are the go-to for pain, swelling, and fever. You’ve probably used ibuprofen or aspirin. They work by blocking chemicals that cause inflammation and pain, so they can be great for headaches, muscle strains, arthritis flares, or period pain.

Common types and how people use them

OTC options include ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin. Prescription-strength options include higher-dose naproxen, diclofenac, and others. There’s also topical diclofenac gel that you rub on sore joints—good when you want pain relief without as much whole-body exposure.

Typical OTC dosing you’ll see on labels: ibuprofen 200–400 mg every 4–6 hours (don’t exceed label limits, often 1,200 mg/day without doctor supervision), naproxen 220 mg every 8–12 hours (follow label limits). Always read the package and check with a pharmacist or doctor if you’re unsure.

Key risks and who should be careful

NSAIDs can cause stomach upset, ulcers, or bleeding—especially if you take them often or with alcohol. They can raise blood pressure and affect kidney function, so people with high blood pressure, kidney disease, or heart disease should be cautious. NSAIDs can also increase the risk of heart problems when used long-term or at high doses.

Don’t mix multiple NSAIDs at once (for example, ibuprofen with naproxen). Avoid taking NSAIDs in the last trimester of pregnancy. If you take low-dose aspirin for heart protection, talk to your doctor before adding other NSAIDs—some combinations reduce aspirin’s heart benefit or raise bleeding risk.

Common drug interactions to watch for

NSAIDs can interfere with or amplify other drugs. Important ones to watch: blood thinners (warfarin, direct oral anticoagulants), some blood pressure medicines (ACE inhibitors, ARBs, diuretics), certain antidepressants (SSRIs), lithium, and methotrexate. If you take any regular prescription, check with your prescriber or pharmacist before starting NSAIDs.

Use the lowest effective dose for the shortest time. If pain lasts more than a few days, or you notice black stools, belly pain, swelling, shortness of breath, or sudden weight gain, contact your doctor. For long-term pain (like arthritis), ask about safer strategies—topical NSAIDs, physical therapy, or non-NSAID pain options.

Quick checklist before you take an NSAID: read the label, avoid mixing with alcohol, don’t combine different NSAIDs, tell your doctor about all meds you take, and ask about topical options if you want less systemic risk. Small changes—like taking pills with food or switching to a gel—can make a big difference in safety and comfort.

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