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NSAID Use: What is safe and appropriate?

Kelley-Ross Pharmacy GroupAsk The PharmacistNSAID Use: What is safe and appropriate?
9.01.2018

QUESTION: What are “NSAID” products and what considerations should I keep in mind when using these products?

ANSWER: Below are answers to some of the more common questions pharmacists get asked about NSAIDs. Please reach out to your physician or one of our pharmacists directly if you have further questions.

 

What’s an NSAID?

NSAID stands for “nonsteroidal anti-inflammatory drug” and it refers to a family of medicines that work in the same way to reduce pain and inflammation from a variety of causes. There are many drugs in this class and some of them require a prescription from your doctor. You may also see the abbreviation “OTC” used here as well as other sources, it stands for “over-the-counter” meaning it may be purchased without a prescription.

The most common NSAIDs found in the pain relief aisle of the pharmacy are:

  • Ibuprofen (Advil® or Motrin®)
  • Naproxen (Aleve®)
  • Aspirin or ASA (Bayer™ or Ecotrin®)

  

 

 

 

 

What are NSAIDs be used for?

Over-the-counter NSAIDs can be used for pain from minor injuries as well as chronic pain from arthritis, old accidents and injuries, and recovery from various procedures.

 

How do NSAIDs work?

NSAIDs work by preventing your body from making a type of chemical that causes inflammation and pain. While these chemicals lead to discomfort, they also provide some protective benefits, so it’s important that NSAIDs are used carefully to keep side effects to a minimum.

 

What are the side effects of NSAIDs?

Many people who use NSAIDs properly do not experience bothersome side effects. Stomach ulcers (including some that may bleed), as well as nausea, vomiting, diarrhea, and an increase in blood pressure are the most common side effects of NSAIDs.

 

What’s the difference between the common NSAIDs?

Ibuprofen, naproxen, and aspirin have a lot of similarities as well as some differences. It’s best to choose one of these NSAIDs and try to use only that one rather than combining them. Combining these medications can increase your risk of side effects and improper dosing.

 

Which NSAID is best for me?

The best NSAID for you is the one that gives you the most pain control at the recommended dosage, and that your doctor and pharmacist know you are using. You’ll want an NSAID that provides you with the most pain relief, least side effects, and has a dosing schedule that works for you.

 

Do I really have to take it with food?

Yes, pharmacists recommend taking NSAIDs with food for a very important reason. Food helps protect the stomach lining from damage, so taking your NSAID with food helps protect you from developing ulcers. Every dose should be taken with at least a little snack.

 

How often can I use these medications?

Always follow the directions on the package, and ask your pharmacist if you’re unsure. Never take more than the recommended dosage at once, and don’t shorten the time between doses. If you follow the directions and are still not getting adequate pain control, you should talk to your doctor.

 

Who should avoid taking NSAIDs?

If you’ve ever had ulcers in your stomach or esophagus, or if you struggle with acid reflux or a “sour stomach”, taking NSAIDs should probably be avoided. Also, if you have uncontrolled high blood pressure or are taking medication for your blood pressure, you should avoid or be extra cautious using these products. People who have any kidney problems may not be good candidates for these medicines and should definitely ask the doctor before using any NSAID. If you have asthma or cardiovascular disease, you should ask your doctor before using NSAIDs.

 

Will these medications interact with my prescriptions?

There are some medications that NSAIDs will interact with. If you take other medications you should consult your doctor or pharmacist prior to using NSAIDs.

 

My doctor told me to take a “baby aspirin” every day but I can’t find a product with that name.

“Baby aspirin” is an old term used to describe a low-dose form of aspirin. Aspirin was often used for children and babies in the past, but it was found to cause a serious reaction (Reye syndrome) in youths when recovering from certain illnesses. Before giving aspirin to those under 18 years of age consult with your doctor. “Low-dose” is the term now used to describe 81 mg aspirin products.

 

I take a low-dose (81 mg) aspirin daily that my doctor recommended for heart health, can I still take NSAID pain relievers?

Yes, but there are a couple of things to keep in mind. The 81 mg daily aspirin is intended to reduce your risk of having a blood clot or heart attack, but it isn’t usually high enough to provide much (if any) pain relief. To get full benefit from your 81 mg aspirin, it is recommended that you take it one to two hours before taking an over-the-counter NSAID for pain relief.

 

What about Tylenol® (acetaminophen)?

Acetaminophen (often abbreviated to APAP or called paracetamol in other countries) is the active ingredient in Tylenol®  and many other over-the-counter pain relief or cold/flu products. Acetaminophen is not an NSAID, so it does not reduce inflammation, but it can be very helpful as pain control for people who should avoid NSAIDs. Additionally, acetaminophen can be safely used along with NSAIDs for pain control, as long as the recommended dosages are not exceeded. If you want to use acetaminophen along with an NSAID, it’s recommended that you take your acetaminophen dose at a different time.

Kelley-Ross is an independently owned corporation operating 4 pharmacies in Seattle. Kelley-Ross provides a wide range of pharmacy services, including prescription dispensing, compounding, medi-set packaging, compliance packaging, long-term care facility services, consultant pharmacist services, immunizations and a variety of health screenings.

We provide Clinical Community Care. This means that our staff combines expert medication therapy management and clinical skills, with caring, patient centered pharmacy services. By using the triad approach – patient, provider and pharmacist – we can help patients maximize their healthcare resources while achieving optimal health outcomes.

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