Safer alternatives to NSAIDs


Nonsteroidal anti- inflammatory drugs (NSAIDs) are commonly used to treat acute and chronic pain associated with conditions such as arthritis. It is also used to reduce fever and inflammation. They can also prevent blood clotting. The most common over-the-counter NSAIDs include ibuprofen, aspirin, and naproxen.

However, these drugs are not without side effects. Non-aspirin NSAIDs are associated with an increased risk of heart attack , stroke , heart failure , and cardiovascular death. Other common side effects include stomach. pain, gas, bloating, and nausea. NSAIDs can also affect kidney function.

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Side effects of NSAIDs

You may experience side effects if you take large amounts of NSAIDs or take medications for a long time. Some side effects are mild and will go away on their own, while others require medical attention to correct them.

The most common side effects of NSAIDs include:

  • Gas
  • Swelling
  • Acidity
  • Abdominal pain
  • Nausea
  • Threw up
  • Diarrhea and / or constipation
  • Dizziness
  • Daze
  • Balance problems
  • I can not concentrate
  • Mild headaches

To reduce gastrointestinal discomfort and symptoms, health professionals recommend taking NSAIDs with food, milk, or antacids. Unless your healthcare provider instructs you to do so, do not take over-the-counter NSAIDs with prescription NSAIDs, various over-the-counter NSAIDs, or more than recommended. This can increase the risk of side effects.

This risk of side effects may be higher in people who:

  • Older
  • You have a history of stomach ulcers or bleeding problems.
  • About anticoagulants
  • You are taking several prescription or over-the-counter NSAIDs.
  • Drink three or more alcoholic drinks a day.

If you experience severe abdominal pain, black stools, bloody urine, blurred vision, chest pain, back pain, hearing problems, or allergic reactions, call your doctor immediately.

Safety tips for NSAIDs

If you are taking NSAIDs (prescription or nonprescription), the safety guidelines are as follows:

  • Take the lowest recommended dose and for the shortest period of time.
  • Always take it with food to avoid an upset stomach.
  • If you have a long-term treatment plan, ask your doctor if you need a COX-2 inhibitor (COX-2 inhibitors are NSAIDs that block the production of certain chemicals that cause inflammation)
  • Check for possible interactions with other medications, supplements, or any over-the-counter medications you are taking.
  • Avoid taking NSAIDs altogether if you've recently had heart bypass surgery, and see your doctor if you have heart disease.

NSAIDs and heart risks

Several studies since 2000 have shown that long-term use of high doses of all NSAIDs except aspirin increases the risk of heart attack, stroke, heart failure, and cardiovascular death . NSAIDs have also been found to increase blood pressure. These risks depend on the drugs and appear to depend on baseline values. cardiovascular risk in people taking NSAIDs.

Although the reasons for the association between NSAIDs and heart risk are not fully understood, there is enough evidence to warn, especially if the likelihood of heart disease increases with age, being overweight, smoking, high cholesterol , blood pressure, or the heart. seizure or stroke. The FDA requires that these risks be clearly identified on the label of these drugs.

Heart problems caused by non-aspirin NSAIDs can occur during the first few weeks of use and can occur more often with higher doses or with prolonged use. Non-aspirin NSAIDs should not be used immediately before or after heart bypass surgery.

For those with an above-average risk of heart disease or multiple risk factors and who take NSAIDs such as diclofenac, celecoxib, or ibuprofen, there are seven to eight cardiovascular events for every 1,000 people taking these drugs. However, research shows that naproxen has the lowest risk compared to other NSAIDs .

The safety of low-dose aspirin

Low-dose aspirin thins the blood, which is usually prescribed to prevent heart attacks or strokes in people at high risk for heart attacks. Before switching to a low-dose aspirin treatment plan, talk to your healthcare provider if you have had ulcers, indigestion, gout or high blood pressure, heavy periods, asthma or lung disease, or a bleeding problem to determine if has a casualty. level. – The aspirin dose is safe for you.

Also, certain medications (other pain relievers such as ibuprofen), vitamins, and herbs can interfere with low-dose aspirin and increase the risk of side effects. Talk to your doctor or pharmacist if you are unsure about taking these low-dose aspirin medications and supplements.

Safer alternatives to NSAIDs

Due to the side effects of NSAIDs, many people are researching alternatives that can help relieve pain and inflammation, including topical NSAIDs, acetaminophen, non-acetylated salicylates, as well as herbs and dietary supplements, yoga, and acupuncture.


Acetaminophen is used to relieve the same types of pain and mild to moderate pain as NSAIDs and to lower fever. Acetaminophen can also be used to relieve osteoarthritis pain. It works by changing the way the body feels pain and cooling the body. Compared to NSAIDs, acetaminophen is easier to tolerate in the stomach, but it can cause liver damage. This can cause side effects ranging from shortness of breath to rashes or blisters on the skin. If you experience any of these side effects, call your doctor as soon as possible.

Topical NSAIDs

Topical NSAIDs have a comparable effect on acute muscle and joint pain with a lower risk of side effects, especially gastrointestinal. Topical NSAIDs are not absorbed into the blood to the same extent as oral NSAIDs, and people using the topical formulation have a lower peak blood drug level and fewer side effects with topical formulations compared to pills. Topical NSAIDs are believed to be better at relieving pain located near the surface of the skin, such as pain in the hands and knees. One study found that topical NSAIDs make life easier for a minority of people with osteoarthritis.

For patients with a history of gastrointestinal bleeding or chronic kidney disease, topical NSAIDs have shown relief and side effects have been rare. However, people using topical NSAIDs should strictly follow the dosing instructions of their healthcare providers, especially those who have had adverse reactions to NSAIDs in the past.

Non-acetylated salicylates

If you are concerned about gastrointestinal damage and bleeding and want to avoid taking aspirin, you can try non-acetylated salicylates. They are more effective than acetaminophen, but much weaker than aspirin. These medications reduce pain and inflammation, but are less likely to damage the stomach or cause heavy bleeding .


Arnica is a plant found primarily in Siberia, as well as parts of Central Europe and North America. The flowers are used medicinally to relieve pain from osteoarthritis, sore throat, surgery, and other ailments. Arnica is commonly used for bruising, bleeding, and swelling. However, there is no scientific evidence to support its effectiveness in these conditions .


Curcumin is derived from turmeric, a relative of the ginger family. It has been used in both Ayurvedic and Chinese medicine to reduce inflammation, as well as to treat digestive disorders and heal wounds. The standard dosage of turmeric powder is 400 to 600 mg three times a day. Side effects are few, but they can cause an upset stomach, and in rare cases, stomach ulcers can appear with high doses. Be careful if you are taking blood thinners or high doses of NSAIDs .


Bromelain is a supplement to reduce pain and swelling in the nose, sinuses, gums, and other parts of the body after surgery or injury. It is used for osteoarthritis, cancer, digestive problems, and muscle pain. Its current form is used for burns .

Research shows that there is conflicting information on whether bromelain, alone or in combination with other substances, relieves osteoarthritis pain or muscle pain after exercise .

Topical capsaicin

Capsaicin is a chemical found in chili peppers that acts on nerve cells in the skin associated with pain. Topical capsaicin is used to reduce muscle and joint pain caused by arthritis, muscle strains, bruises, cramps, and sprains.

Capsaicin comes in a variety of topical forms for the skin, such as ointments, creams, gels, oils, and multiple doses. Tell your doctor or pharmacist about other prescriptions you can take and about vitamins, supplements, and herbal products.


Acupuncture is a technique used in traditional Chinese medicine. By inserting fine needles into specific areas of the body, acupuncture can stimulate specific points to relieve pain or other conditions. Research shows that acupuncture can help relieve chronic pain in the lower back, neck, and knees, and in people with osteoarthritis. Acupuncture can have several serious side effects if not done correctly. These include punctured organs, infections from unsterilized needles, collapsed lungs, and damage to the central nervous system .

Yoga for pain

Research shows that yoga can help relieve pain in certain conditions. Some of the symptoms of fibromyalgia can be alleviated with yoga and other forms of exercise, such as muscle strength training, massage, and acupuncture. A review of 25 2020 randomized controlled trials examined its effect on back pain. Twenty studies have shown positive results for pain, depression, and anxiety. However, there was no noticeable difference in pain after six weeks of yoga and physical therapy .

Get the word of drug information

Nobody wants to be in pain, be it a mild headache or after a surgical procedure. NSAIDs have helped millions of people cope with pain, but they have side effects that can turn into serious health problems. Be aware of side effects and tell your doctor what other medications you are taking so that the proper dosage can be prescribed for you. And remember to notify your healthcare provider right away of any side effects you experience so they can change the dose or prescribe a different medication to ease your pain.

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