One type of arthritis pain relievers are NSAIDs - nonsteroidal anti-inflammatory drugs. These are medicines that reduce inflammation and relieve pain. Inflammation is the body's response to irritation or injury, and is characterized by redness, warmth, swelling, and pain. NSAIDs are used to treat a variety of conditions that cause inflammation, including arthritis and tendinitis. NSAIDs also are used to treat pain from injury or other causes of long-term pain.

Over-the-Counter Drugs

These Include:

BRAND NAME	GENERIC NAME
Advil, Nuprin, Motrin	ibuprofen
Aleve	naproxen sodium
Ascriptin, Bayer, Ecotrin	aspirin
Orudis KT	ketoprofen

Prescription Drugs

These include:

BRAND NAME	GENERIC NAME
Anaprox	naproxen sodium
Celebrex*	celecoxib
Clinoril	sulindac
Daypro	oxaprozin
Disalcid	salsalate
Feldene	piroxicam
Indocin	indomethacin
Lodine	etodolac
Mobic	meloxicam
Naprelan	naproxen sodium
Naprosyn	naproxen
Orudis	ketoprofen
Relafen	nabumetone
Toradol	ketorolac tromethamine

* The Cox-2 inhibitor Celebrex is a newer form of NSAID that also relieves inflammation. It is less likely to result in unwanted side effects that can occur with older types of NSAIDs, especially stomach bleeding. While Celebrex is generally safer in this regard, there is still some risk to the stomach.

Celebrex and all NSAIDs must carry a warning on the label that users may face an increased risk of cardiovascular side effects as well as gastrointestinal bleeding.

How Do NSAIDs Work?

NSAIDs work by blocking the production of certain chemicals in the body that cause inflammation.

Do All NSAIDs Work the Same Way?

There appears to be no fundamental difference in the ability of different NSAIDs to reduce pain and inflammation. However, you might find that you get more relief from one NSAID over another and some NSAIDs may have fewer side effects than others. Some NSAIDs also may be more convenient for people, since they only need be taken once or twice a day.

What Are the Common Side Effects of NSAIDs?

Although NSAIDs are reasonably safe medications, it is important that you are aware of potential side effects. In 2005, the FDA asked makers of NSAIDs to revise their labels to include more specific information on risks including potential heart attack, stroke, stomach bleeding.

NSAIDs are safest when low doses are taken for brief periods. Side effects most commonly occur if you are taking large doses over a prolonged time (months or years). Some side effects are mild and go away on their own or after reducing the dose. Others may be more serious and need medical attention.

Common side effects of NSAIDs include:

Stomach pain and heartburn
Stomach Ulcers.
General bleeding tendency increases while taking NSAIDs, especially aspirin. Your doctor might tell you to stop NSAIDs before surgery. Ask your doctor before taking NSAIDs if you are on blood-thinning medications (such as Coumadin).
Headaches and dizziness.
Ringing in the ears may result from certain NSAIDs, including aspirin. This can usually be eliminated by decreasing the dose.
Allergic reactions such as rashes, wheezing, and throat swelling
Liver or kidney problems. These problems can be evaluated by blood tests in people who take NSAIDs for prolonged periods. People with any kidney problems should not take NSAIDs without checking with their doctor.
High blood pressure
Leg swelling

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Do You Have Fibromyalgia Pain?

Cymbalta is approved for the management of fibromyalgia.

Important Safety Information

Cymbalta^® (duloxetine HCl) is approved for the treatment of depression and generalized anxiety disorder, and for the management of diabetic peripheral neuropathic pain and fibromyalgia.

What should I talk about with my healthcare provider?

Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.

You should also know that:

Suicide is a known risk of depression and some other psychiatric disorders.
Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents, and young adults especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults over age 24, and risk decreased for those over age 65.
All patients starting therapy should be monitored appropriately and observed closely for new or worsening depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior.
Cymbalta^® is not approved for use in patients under age 18.

Who should NOT take Cymbalta?
You should not take Cymbalta if:

You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
You have uncontrolled narrow-angle glaucoma (an eye disease)
You are taking Mellaril^® (thioridazine)

What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, tell your healthcare provider:

about all of your medical conditions, including kidney problems, glaucoma, or diabetes
about your alcohol use
if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life threatening condition
if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant

While taking Cymbalta, tell your healthcare provider:

if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
before stopping Cymbalta or changing your dose
if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose. Your healthcare provider may periodically check your blood pressure while you are taking Cymbalta

If you have any questions, talk to your healthcare provider before taking Cymbalta.

What are the possible side effects of Cymbalta?

The most common side effect of Cymbalta was nausea. For most people who had it, the nausea was mild to moderate. Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and, increased sweating. This is not a complete list of side effects.

Safety Information and Boxed Warning | Prescribing Information | Medication Guide