What Are OTC Anti-Inflammation Drugs?

Medically Reviewed by Zilpah Sheikh, MD on February 07, 2024
5 min read

Even mild chronic pain, whether from arthritis, migraines, or another condition, can really get to you. Naturally, you want to make the hurt go away. But what type of pain reliever do you need?

Many are nonsteroidal anti-inflammatory drugs (NSAIDs ). They block the effects of chemicals called prostaglandins that are involved in inflammation. The result: less swelling and pain.

Some NSAIDs need a prescription. Others are sold over the counter (OTC), which means you don’t need a prescription to buy them. The most common OTC NSAIDs are:

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

Other NSAIDs available by prescription include celecoxib (Celebrex, Elyxyb), diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), ketorolac, nabumetone (Relafen), oxaprozin (Coxanto, Daypro) and sulindac (Clinoril).

It depends on what the problem is, and what’s suitable for you. Your doctor can help you decide. Or if you’re in the drugstore and wondering what to try, ask the pharmacist.

Remember, even if you don’t need a prescription, medicines can still have side effects. Be sure to follow the dosing instructions. Don’t take too much, or for too long.

If you need pain medicine for more than 10 days, talk to your doctor to see which one is right for you.

Tell your doctor about everything you take, even if you bought it over the counter. They can check to make sure it’s OK for you.

Before recommending a specific pain pill, your doctor will consider:

  • Your medical history
  • Your current health concerns
  • Other medicines you take
  • Allergies and past reactions to meds
  • How well your liver and kidneys work
  • Any surgeries you’ve had
  • Your overall treatment plan and goals

While the details are different, all of the different NSAIDs work in more or less the same way. 

When you injure yourself, the damaged tissue releases certain chemicals. These chemicals cause the tissue to swell, and they amplify the feeling of pain. NSAIDs work by blocking the effects of these chemicals. As a result, you get less swelling and pain.

Reducing swelling is what makes NSAIDs different from other painkillers. 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.

For most people, side effects from NSAIDs, if any, are minor. The most common ones include:

Serious ones are rare. But they're concerning enough for the FDA to require warnings on the packaging. They can include:

Heart attacks and strokes. NSAIDs -- except aspirin -- have the potential to increase the risk of heart attacks and strokes, especially when you take high doses or take them for a long time. However, aspirin taken in low doses with a doctor's supervision can lower your risk of a heart attack or stroke because it reduces the risk of blood clots.

High blood pressure. All NSAIDs have the potential to raise blood pressure. They can also interfere with blood pressure medicine, making it less effective. However, because of aspirin's cardiovascular benefits, your doctor may recommend you take it if you're at risk for a heart attack or stroke.

Heartburn, ulcers, and gastrointestinal (GI) bleeding. Most NSAIDs increase the risk of GI problems. The risk goes up if you drink alcohol while you're taking them. Celecoxib is the NSAID least likely to cause problems because it was designed to avoid GI side effects.

Allergic reactions. NSAIDs can cause allergic reactions, resulting in wheezing, hives, facial swelling, and shock. Dangerous side effects may be more common in people with asthma, especially if they also have sinus problems or nasal polyps -- tissue growths on the inside of the nasal cavity.

You might also have:

  • Bleeding in places other than the GI tract
  • Kidney disease
  • Muscle cramps
  • Hearing problems

Side effects vary among different NSAIDs. Your doctor or pharmacist can give you specific information about the side effects of the particular drug you're taking.

It's critical to be monitored by your doctor if you're taking any medicine regularly for longer than a couple of weeks. Careful monitoring can catch side effects early.

Some people shouldn't take an NSAID. Tell your doctor if:

  • You're allergic to aspirin or any other pain reliever.
  • You drink more than three alcoholic drinks a day.
  • You have stomach ulcers or bleeding in your digestive system.
  • You have liver or kidney disease.
  • You have heart disease.
  • You take blood-thinning medicine or have a bleeding disorder.

Many NSAIDs aren't safe for pregnant women, especially in the last 3 months. Children and teenagers under 18 years old shouldn't take aspirin unless directed by their doctor, due to the risk of a serious condition called Reye's syndrome.

Consider the following when deciding whether to take an NSAID and which one is best for you:

  • NSAIDs are a common class of OTC and prescription painkillers. Examples include aspirin, ibuprofen, naproxen sodium, and prescription drugs such as celecoxib.
  • You should never take any OTC medicine regularly without discussing it with your doctor. Most OTC painkillers should not be used for more than 10 days.
  • Like any medicine, OTC and prescription NSAIDs have potential side effects. These include a higher risk for gastrointestinal bleeding, heart attack, stroke, and allergic reactions.
  • NSAIDs are not alike. They can have very different pros and cons. Talk to your doctor about the NSAID that might work best for you.
  • NSAIDs can appear in many places. For instance, OTC medicines for colds and the flu may contain doses of these pain relievers. Make sure you know the ingredients of any medicine you use.
  • There are alternatives to NSAIDs. Many people who can't take NSAIDs benefit from acetaminophen. Other options for people with severe chronic pain are prescription narcotics. Some find that physical therapy, weight loss (if overweight), biofeedback, yoga, meditation, and acupuncture can also reduce their pain.
  • In some people, complete pain relief isn't possible. But you can focus on reducing your pain so that it doesn't interfere with your life.