Non-Steroidal Anti-Inflammatory Drugs (Oral NSAIDs)

What is Non-Steroidal Anti-Inflammatory Drugs (Oral NSAIDs) for?

Non-steroidal anti-inflammatory drugs (NSAIDs) are a group of medications commonly used to treat pain and reduce inflammation. It can also be used to bring down the body temperature during a fever and to relieve headaches, joint or muscle pain/inflammation, gout attacks, toothaches and menstrual pain.

Examples of oral NSAIDs available over the counter include Ibuprofen and Naproxen. Other NSAIDs which require a prescription from the doctor include Diclofenac, Mefenamic Acid, Ketoprofen, Piroxicam, Indomethacin, Celecoxib and Etoricoxib.

How should I take or use Non-Steroidal Anti-Inflammatory Drugs (Oral NSAIDs)?

As there are different strengths and dosage forms for these medications, please make sure to take it as recommended on the label. Please check with your healthcare professional if you are unsure.

NSAIDs should be best taken with meals to reduce stomach irritation. Your healthcare professional may also give you an additional medication to protect the stomach. E.g. famotidine, omeprazole.
Do not exceed the dose recommended on the label as taking too much NSAIDs over time may cause serious stomach, kidney or heart problems.

What should I do if I forget to take or use Non-Steroidal Anti-Inflammatory Drugs (Oral NSAIDs)?

NSAIDs can be taken on as needed basis for short term use or regularly for certain conditions as prescribed by the doctor. 

If your doctor has prescribed NSAIDs for you to be taken regularly, do not stop taking your medication without checking with your healthcare professional. If you miss a dose, take the missed dose as soon as you remember. If it is almost time for your next dose, take only the usual dose. Do not double your dose or use extra medication to make up for the missed dose.

What precautions should I take when taking or using Non-Steroidal Anti-Inflammatory Drugs (Oral NSAIDs)?

Inform your healthcare professional if:

• You are allergic to this class of medications or aspirin or any of the other ingredients in this medication
• You are pregnant, planning to become pregnant, or breastfeeding.
• You are taking any other medications, including supplements, traditional medications and herbal remedies.
• You have a history of stomach or bowel ulcers or bleeding, or bleeding problems.
• You have asthma.
• You have a history of kidney, heart problems or stroke.
• You are planned for any medical procedures, surgeries or dental procedures.

Unless advised by your doctor, NSAIDs should be used at the lowest effective dose and for the shortest possible time. Prolonged use without medical supervision should be avoided as this may increase the risk of heart attacks or stroke, kidney problems and stomach ulcers.

What food or medication should I avoid when I take or use Non-Steroidal Anti-Inflammatory Drugs (Oral NSAIDs)?

Do let your healthcare professional know if you are taking any other herbs, supplements or medications.

This includes the following medications:

• Aspirin
• ACE inhibitors (e.g. Captopril, Enalapril, Lisinopril) or Angiotensin II receptor blockers (e.g. Candesartan, Losartan, Valsartan)
• Oral Corticosteroids (e.g. Prednisolone)
• Diuretics (e.g. Frusemide)
• Blood thinning medications (e.g. Clopidogrel, Dabigatran, Warfarin)

Avoid taking excessive amounts of alcohol when taking NSAIDs as this will increase the risk of bleeding in the stomach.

What are some common side effects of Non-Steroidal Anti-Inflammatory Drugs (Oral NSAIDs)?

• Side effects of NSAIDs may include:
• Stomach discomfort/irritation e.g. stomach pain, heartburn
• Taking this medication after food reduces the risk of this side effect
• Mild bleeding such as 
• Unexplained nose bleed
• Bleeding from gums when brushing teeth
• Bleeding from small cuts for 10-15 minutes even as you apply pressure on the wound. Check with your healthcare professional if the bleeding does not stop within 15 minutes or if you feel unwell. 

Inform your healthcare professional if these side effects do not go away and are bothersome to you.

• Patients taking NSAIDs may have increased risk of bleeding. If you experience any serious bleeding, you should stop the medication and inform your healthcare professional immediately.

           Serious bleeding may include one or more of the following:

• Blood in the urine
• Black and sticky stools (if you are not using iron supplements at the same time)
• Unexplained large bruises
• Cough up blood or coffee ground-like vomit
• Sudden severe headache with nausea or loss of consciousness

• The symptoms of a drug allergy include one or more of the following:
• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

• If you experience any of the following symptoms, you should stop your medication and see your healthcare professional immediately.
• Chest pain
• Breathlessness
• Swelling or sudden weight gain

How should I store Non-Steroidal Anti-Inflammatory Drugs (Oral NSAIDs)?

• Keep away from children
• Keep in a cool, dry place, away from direct sunlight

How do I throw away Non-Steroidal Anti-Inflammatory Drugs (Oral NSAIDs) safely?

Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.

What else should I know about Non-Steroidal Anti-Inflammatory Drugs (Oral NSAIDs)?

If you experience the following symptoms, your condition may be too serious for self-treatment and you should consult a doctor:

• Ongoing fever even after 3 days of treatment
• Ongoing headache that lasts for more than 2 days
• No improvement in pain after 7 days of treatment
• Any of the above symptoms worsen after treatment