NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) and Arthritis
Who Is More Likely to Develop Stomach Ulcers and Bleeding While Taking NSAIDs?
Anyone can develop a stomach ulcer while taking NSAIDs. But having several of the following factors may raise your risk:
- Over 60 years old
- History of stomach ulcers
- Cigarette smoking
- Multiple medical problems
- Three or more alcoholic drinks daily
- Use of anti-inflammatory steroids, such as prednisone
- Kidney failure (when taken for longer period of time and/or higher doses)
How Can NSAID Side Effects Be Minimized?
There is no way to completely avoid the side effects of any drug, but you and your doctor can minimize your risk of developing some side effects from NSAIDs. For example:
- Use acetaminophen (Tylenol) instead of NSAIDs for pain relief that your doctor doesn't feel requires an anti-inflammatory drug.
- Take the minimal amount of NSAIDs that you need for your condition.
- Take NSAIDs with food.
- If you don't need 24-hour a day relief, avoid one-dose-a-day types of NSAIDs, especially if you are over age 60. These medications stay in your system longer and may cause more side effects.
- Ask your doctor about taking a second drug, such as a stomach acid blocker that can reduce your risk of injuring the stomach. Some medications combine an NSAID and an acid blocker in one pill.
If you have persistent or unusual pain in your stomach after starting an NSAID, tell your doctor right away.
How Are NSAIDs Prescribed?
NSAIDs are prescribed in different doses depending on your condition. Dosages may range from one to four times per day, depending on how long each drug stays in the body. Your doctor may prescribe higher doses of NSAIDs if you have rheumatoid arthritis (RA), for example, because frequently there is a significant degree of heat, swelling, redness, and stiffness in the joints in RA. Lower doses may be adequate for osteoarthritis and muscle injuries, since there is generally less swelling and often no warmth or redness to the joints.
No single NSAID is guaranteed to work. Your doctor may prescribe several types of NSAIDs before finding one that works best for you.