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Osteoarthritis Health Center

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Are Anti-Inflammatory Pain Relievers Safe for You?

Here's help weighing the benefits and risks of NSAIDs, from aspirin to Celebrex

Understanding NSAIDs

There is no question that the risks of NSAIDs can be serious, even life-threatening.

According to the American Gastroenterological Association (AGA), each year the side effects of NSAIDs hospitalize over 100,000 people and kill 16,500 in the U.S., mostly due to bleeding stomach ulcers.

But it's important to put those numbers in context. The AGA also says that every day, more than 30 million Americans use NSAIDs for pain from headaches, arthritis, and other conditions. And while some experts emphasize the dangers, others stress that living with chronic pain is terrible in itself.

"Pain is not just an inconvenience," says rheumatologist John Klippel, MD, President and CEO of the Arthritis Foundation, Atlanta, GA. "It can be devastating. It can destroy people's lives. NSAIDs can be a valuable treatment."

Before you can decide what medicine is right for you, it helps to understand NSAIDs. NSAIDs are a common class of painkillers. They include all non-steroidal anti-inflammatory medicines, even aspirin, which helps protect the heart. The most common over-the-counter NSAIDs are:

  • Aspirin (Bayer, Ecotrin, and St. Joseph)
  • Ibuprofen (Advil, Motrin IB, Nuprin)
  • Ketoprofen (Actron, Ordus KT)
  • Naproxen sodium (Aleve)

Other NSAIDs available by prescription include Daypro, Indocin, Lodine, Naprosyn, Relafen, and Voltaren.

Cox-2 inhibitors are a newer form of prescription NSAID. Two of them -- Bextra and Vioxx -- are no longer sold because of concerns about their side effects. The third, Celebrex, is still available.

How Anti-Inflammatory Pain Relievers Work

While the details are different, all of these medicines work in more or less the same way. They block the effects of chemicals that increase the feeling of pain. Unlike many other painkillers, they also help by reducing swelling, which can further reduce pain. Sometimes swelling is a key cause of pain.

But the problem with NSAIDs -- or any systemic drug -- is that they can affect the entire body, not just the part that hurts.

"If you use a drug to ease one problem, like an achy joint," Goldberg tells WebMD, "it's likely to cause a different reaction somewhere else too."

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