What Are NSAIDs for Rheumatoid Arthritis?

Medically Reviewed by David Zelman, MD on October 31, 2021
4 min read

NSAIDs -- or nonsteroidal anti-inflammatory drugs -- are commonly used to treat rheumatoid arthritis. They help manage the chronic pain, inflammation, and swelling that are characteristic of RA.

They do not slow down the disease. Most people with RA also take other types of medications, such as methotrexate or biologics, to help prevent further joint damage.

They block your body’s “Cox” enzymes. This cuts down on inflammation and reduces pain and stiffness.

These include:

Arthrotec is an NSAID that combines diclofenac with another active ingredient, misoprostol, that helps prevent stomach irritation.

Prevacid Naprapac combines naproxen with the acid blocker Prevacid to lower your chances of getting stomach ulcers.

Vimovo is a combination of naproxen and the acid blocker Nexium.

All prescription NSAIDs are linked to a higher risk of heart attack and stroke. They carry a warning about that.

While the actual risk of a heart attack and stroke with NSAIDs is unknown, medical studies are in progress to help find that answer. The risk is likely greatest for people who have heart disease risk factors, such as high blood pressure, high cholesterol, diabetes, and smoking.

You and your doctor can weigh the risks and benefits.

The most common ones include:

NSAIDs may also raise blood pressure. If you have high BP, keep a close eye on your blood pressure. Let your doctor know if it goes up.

Most people take these meds with few to no side effects, though.

The chance of getting an ulcer or stomach bleeding rises even more if you also take corticosteroids (often called "steroids") for RA or blood thinners, or anticoagulants. Also, the longer you use NSAIDs, the greater the risk of stomach bleeding and ulcers.

Older adults, especially those who are over age 65, are more likely to get stomach bleeding and ulcers, as do those who drink alcohol and smoke cigarettes.

If you take NSAIDs to ease the inflammation, pain, and stiffness of RA, talk with your doctor about ways to protect your stomach. If you’re at high risk for stomach bleeding, you may need a strong stomach acid blocker to help prevent ulcers.

Your doctor will check on that. NSAIDs can reduce blood flow to the kidneys, which may cause these organs not to work as well. This makes fluid build up in your body, which can raise your blood pressure.

So, if you take these meds, you will probably get a blood test from time to time to check how well your kidneys work.

They can cause allergies. Some people with asthma are sensitive to some NSAIDs. The drugs may worsen breathing, and many specialists recommend that people who have asthma not take certain NSAIDs. The risk may be greater in people with sinus problems or nasal polyps.

If you have asthma, make sure your arthritis doctor knows. Some NSAIDs may be safer for you.

Use NSAIDs with caution if you have kidney or liver disease, heart failure, high blood pressure, diabetes, lupus, asthma, or ulcers.

Tell your doctor about all drugs and supplements you take. NSAIDs may interact with blood thinners, cyclosporine, lithium, or methotrexate. Let your doctor know if you're sensitive to aspirin.