How NSAIDs work is by blocking the cyclooxygenase enzyme, also referred to as COX 1 & 2. This enzyme speeds up the production of prostaglandin. Why the reduction in production of prostaglandin is important is because it promotes:
In the scheme of health, prostaglandins play a vital role. The problem comes in when they over do it. So sometimes, scaling back their activity can be a welcomed relief.
Thus, taking a NSAID will reduce pain, inflammation and fever. An anti inflammatory is commonly taken to treat:
- muscle soreness
- menstrual cramps
- kidney stone caused pain
- sports injury ~ sprain & strain
Aspirin is also a nonsteroidal anti-inflammatory, yet it has the additional property as a blood clotting inhibitor, even at a low dose. This feature is a health benefit for those at a high risk of a stroke and heart attack.
For those that suffer bouts of gout, aspirin is not beneficial for gout pain because it can raise the uric acid level in your blood. And because uric acid crystals are what cause your excruciating pain, then less is best.
NSAIDs are classified according to whether they stop both COX-1 and COX-2 enzymes or just COX-2. This distinction is important because selective COX-2 inhibitors don’t have much of an affect on prostaglandin action involved in protecting your stomach lining. (More on this drug side effect below.)
The list of nonsteroidal anti-inflammatories that impede the enzymatic action of COX-1 and COX-2 is fairly substantial. So here’s a list of the more traditional ones that require a prescription:
- mefenamic acid
For now, the only COX-2 inhibitor available in the U.S. is celecoxib.
On the nonsteroidal anti-inflammatory list that can be purchased without a prescription are:
- naproxen sodium
You’ll notice more than one NSAID made both lists because a higher strength may require a health care providers signature. And acetaminophen is a pain reliever and fever reducer, but not an anti-inflammatory.
Non-steroidal anti-inflammatory drug is so aptly named because it reduces inflammation without the side effects of a steroid. Steroids, like prednisone, cortisone, etc., have potentially serious side effects. Whereas, non-steroidal anti-inflammatory drugs don’t cause these same side effects.
The side effect that garners the greatest concern when you take a nonsteroidal anti-inflammatory is its impact on your stomach and upper intestinal lining. As mentioned previously, prostaglandins play a role in protecting your lining from acid. And COX-1 enzymes are the catalyst for this action, while COX-2 isn’t immersed in this antacid process.
Therefore, taking a NSAID that inhibit COX-1 has the potential to cause these stomach and intestinal related side effects:
Although these digestive associated side effects can occur with the occasional use of NSAIDs, the risk is greater with frequent and high dosage use.
A couple of symptoms that might indicate gut bleeding caused by an anti-inflammatory are bloody stools, hematemesis or hemoptysis. Granted, you can have significant bleeding without experiencing any symptoms.
When you stop taking your chosen NSAID, ulcer healing can be expected. Also, taking a H2 blocker or proton pump inhibitor may help treat a NSAID caused ulcer and its corresponding bleeding side effects.
A nonsteroidal anti-inflammatory can cause some other drug side effects as well, like:
- dry mouth
- excess gas
- easy bruising
- vision changes
- abdominal pain
- muscle cramps
- nausea, vomiting
- decreased appetite
- diarrhea, constipation
- drowsiness, insomnia
- excessive wound bleeding
- extreme weakness, fatigue
- easy sunburn due to skin’s sun sensitivity
Serious side effects can occur, particularly if you’re taking a prescription NSAID. So don’t hesitate to inform your health care provider ASAP should any of these side effects develop.
Asthma sufferers are at a higher risk for experiencing a serious allergic reaction to NSAIDs.
Severe potential side effects of NSAIDS are kidney failure, liver failure and unstoppable bleeding after an injury. Solely based on these dire consequences, don’t pop a NSAID for all your minor aches. Allow yourself to feel a little pain.
Another major health concern about just popping a nonsteroidal anti-inflammatory indiscriminately is atherosclerosis. They can impair blood vessels relaxation and may stimulate smooth muscle cell growth inside your arteries. As a consequence, it raises your risk for a heart attack, stroke and blood vessel related health conditions. With the exception of low dose aspirin.
Also, you should check with your health care provider before taking a NSAID if:
- on diuretics
- history of ulcers
- have hypertension
- on medication for arthritis, diabetes
- take blood thinners ~ warfarin, heparin
- have kidney, liver, heart related health condition
- drink more than a couple of beverages containing alcohol a day
- experience intermittent stomach pain, upset stomach, heartburn
No matter the type of nonsteroidal anti-inflammatory you chose, it should always be used with caution.