Top 10 Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs – a “magic” pill for headache, toothache, menstrual, muscle or joint pain. It is important to understand that non-steroidal anti-inflammatory drugs only eliminate the symptom, but do not affect the very cause of the pain.

30 million people daily use non-steroidal anti-inflammatory drugs for pain relief. Let’s figure out what is the difference between different groups of NVPS, for which diseases they are prescribed, and what side effects they may have.

List of top 10 inexpensive and effective non-steroidal anti-inflammatory drugs according to KP

1. Aspirin

Aspirin is prescribed for pain of any nature (muscular, joint, menstrual) and elevated body temperature. This drug is included in the list of vital medicines of the Russian Federation. Aspirin also reduces the adhesion of platelets to each other and thins the blood, so it can be prescribed for long-term use at a low dosage for the prevention of cardiovascular diseases. The maximum daily dosage is 300 mg.

Противопоказания:increased tendency to bleeding, children under 15 years of age.

suitable for pain of any nature, affordable price.
with prolonged use, it has a negative effect on the stomach; possible development of bronchial asthma associated with aspirin.
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2. Diclofenac

Diclofenac is most often prescribed for inflammatory diseases of the joints (arthritis). Also, the drug is actively used for muscle pain, neuralgia, for pain after injuries or operations, for pain syndrome against the background of inflammatory diseases of the upper respiratory tract and small pelvis (adnexitis, pharyngitis). The maximum single dosage is 100 mg.

Contraindications: bleeding of unknown origin, stomach or duodenal ulcer, last trimester of pregnancy.

universal application; there are several forms of release (gel, tablets).
with caution is prescribed to the elderly; contraindicated in edema.

3. Ketanov

Ketanov is prescribed for pain of moderate to severe intensity. Also, the drug is effective in the pain syndrome that accompanies cancer, and after surgery. The analgesic effect occurs 1 hour after ingestion, and the maximum effect is achieved after 2-3 hours. The maximum daily dosage is 40 mg. It is also worth remembering that Ketorolac is not used to treat chronic pain. Do not use more than two days without consulting a doctor.

Противопоказания: pregnancy, lactation, liver failure, hypersensitivity to NSAIDs, ulcerative erosive lesions of the gastrointestinal tract in the acute stage.

pronounced analgesic effect; applicable for any pain (except chronic).
a strong negative effect on the gastric mucosa.

4. Ibuprofen

The drug is used to relieve short-term pain or fever with colds. The duration of the analgesic effect lasts about 8 hours. The maximum daily dosage is 1200 mg, while it is not recommended to take the drug for more than 3 days without a doctor’s recommendation.

Противопоказания: hypersensitivity to ibuprofen, erosive and ulcerative diseases and bleeding of the gastrointestinal tract, bronchial asthma, severe cardiac, renal and hepatic insufficiency, blood clotting disorders, pregnancy (3rd trimester), children under 3 months of age, some rheumatological diseases (systemic lupus erythematosus).

universal application; long lasting analgesic effect.
an extensive list of contraindications, can not be taken longer than 3 days.
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5. Ketoprofen

Ketoprofen is often prescribed for inflammatory diseases of bones, joints and muscles – arthritis, arthrosis, myalgia, neuralgia, sciatica. Also, this drug is effective for relieving pain after trauma, surgery, renal colic. The maximum daily dosage is 300 mg.

Противопоказания: peptic ulcers of the gastrointestinal tract, children under 18 years of age, pregnancy (3rd trimester), severe liver and kidney failure.

pronounced analgesic effect; suitable for various pains.
only one-time use is recommended; negatively affects the gastrointestinal tract.

6. Nalgezin Forte

Nalgezin Forte is used to relieve pain in inflammatory diseases of the joints, bones, muscles, headaches and migraines. Also, the drug is effective for fever during a cold. The maximum daily dosage is 1000 mg. With prolonged use, it is necessary to monitor kidney function.

Противопоказания: erosive and ulcerative lesions of the gastrointestinal tract in the acute phase, hematopoietic disorders, severe impairment of kidney and liver function, children under 12 years of age, hypersensitivity to naproxen and other NSAIDs.

universal application; effective as an antipyretic.
an extensive list of contraindications.

7. Meloxicam

Meloxicam is prescribed for various arthritis (osteoarthritis or rheumatoid arthritis), as it quickly and effectively relieves pain and inflammation. In this case, it is strongly recommended to start treatment with a minimum dosage and increase if necessary. Also, when taking Meloxicam, side effects such as abdominal pain, diarrhea, flatulence, nausea are possible.

Противопоказания: hypersensitivity to the components of the drug, decompensated heart failure, erosive lesions and bleeding of the gastrointestinal tract, pregnancy and breastfeeding, children under 12 years of age.

pronounced analgesic effect in rheumatological diseases.
possible side effects; the need for careful dosage selection.

8. Nimesulide

Nimesulide is used for various types of pain: dental, headache, muscle, back pain, as well as in the postoperative period, after injuries and bruises. The maximum single dose is 200 mg. In this case, the drug should not be taken for colds and SARS. Doctors also warn that Nimesulide can cause side effects such as dizziness, drowsiness, headache, excessive sweating, urticaria, itchy skin.

Противопоказания: pregnancy and lactation, bronchospasm, urticaria, rhinitis caused by taking NSAIDs, children under 12 years of age.

prolonged analgesic effect (more than 12 hours).
contraindicated in fever during colds, adversely affects the gastrointestinal tract.

9. Celecoxib

Celecoxib is considered one of the safest NSAIDs. The drug is used to relieve joint, muscle pain, and is also used to relieve an attack of acute pain in adults.1. Doctors recommend starting treatment with a minimum dosage and increasing if necessary.

Противопоказания: severe violations of the kidneys and liver, allergic reactions to taking acetylsalicylic acid or other NSAIDs in history, III trimester of pregnancy, lactation.

safe for the gastrointestinal mucosa, helps with various types of pain.
dosage selection is required.

10. Arcoxia

The active substance contained in the composition is etoricoxib. The drug is intended for the treatment of chronic pain (including rheumatological diseases), as well as pain after dental surgery.2. The maximum daily dosage is 120 mg.

Противопоказания: pregnancy, lactation, erosive and ulcerative changes in the mucous membrane of the stomach or duodenum, active gastrointestinal bleeding, cerebrovascular or other bleeding, children under 16 years of age.

pronounced analgesic effect.
does not reduce fever, will not help with all types of pain.

How to choose non-steroidal anti-inflammatory drugs

All non-steroidal anti-inflammatory drugs are divided into several groups. They differ in duration of action, efficacy in relieving pain and inflammation, and chemical structure.3.

According to the duration of action, short-acting (exposure period of about 6 hours) and long-acting (exposure period of more than 6 hours) non-steroidal anti-inflammatory drugs are distinguished.

Also, NSAIDs differ in the effectiveness of the anti-inflammatory effect and analgesic effect. Anti-inflammatory effect (from maximum to minimum) have: indomethacin – diclofenac – ketoprofen – ibuprofen – aspirin. According to the severity of the analgesic effect (from maximum to minimum): ketorolac – ketoprofen – diclofenac – indomentacin – ibuprofen – aspirin4.

Reviews of doctors about non-steroidal anti-inflammatory drugs

Celecoxib has been praised by many physicians as an effective treatment for chronic rheumatic pain. In addition, Celecoxib is considered the “gold standard” for low risk of gastrointestinal complications.

Also, experts recommend Naproxen, which is well tolerated by patients and does not cause side effects when used for no more than 21 days.5.

Many rheumatologists highlight the drug Etoricoxib (Arcoxia), which is effective for many conditions that involve pain. One of its main advantages is a convenient dosing regimen and the speed of the onset of the effect.

Popular questions and answers

We discussed important issues related to non-steroidal anti-inflammatory drugs with general practitioner the highest category Tatyana Pomerantseva.

Why are non-steroidal anti-inflammatory drugs dangerous?

– NVPS are dangerous because they can cause side effects. The most common of them:

• NSAIDs – gastropathy (in 68% of patients taking drugs for at least 6 weeks) – manifested by the formation of ulcers, erosions, gastric bleeding, perforations;

• kidneys – acute renal failure, fluid retention;

• cardiovascular system – violation of blood clotting processes;

• nervous system – headache, sleep problems, memory problems, depression, dizziness;

• hypersensitivity – increased risk of developing bronchial asthma;

• damage to the liver.

What is the difference between steroid and non-steroid drugs?

– Steroid anti-inflammatory drugs are hormonal drugs. And nonsteroidal drugs are organic acids. Unlike NSAIDs, steroid drugs affect the metabolic processes in the body and the immune system. Steroid drugs are prescribed in case of high disease activity, in the presence of pathological processes from other organs and systems, chronic pain, joint pain (in rheumatology), in case of ineffectiveness of NSAIDs or contraindications to them.

How long can nonsteroidal drugs be used?

NSAIDs are painkillers that do not treat the cause of the pain. Therefore, you can take drugs on your own for no more than 5 days. If the pain persists, you should definitely consult a doctor.

How to protect the gastric mucosa from the aggressive effects of NSAIDs?

– It is necessary to take proton pump inhibitors (PPIs) in parallel with the course of NSAIDs. PPIs include Omeprazole, Pariet, Nolpaza, Nexium. These drugs reduce the secretion of hydrochloric acid by special mucosal cells and provide some protection to the gastric mucosa.

Are there safe NSAIDs?

There are no non-steroidal anti-inflammatory drugs that are absolutely safe for health. It’s just that the severity of side effects in some drugs is much less. Naproxen and Celecoxib are considered the safest.
  1. Karateev A. E. Celecoxib: evaluation of efficacy and safety in the second decade of the 2013st century // Modern Rheumatology. 4. No. XNUMX. URL: https://cyberleninka.ru/article/n/tselekoksib-otsenka-effektivnosti-i-bezopasnosti-vo-vtorom-desyatiletii-xxi-veka
  2. Kudaeva Fatima Magomedovna, Barskova V. G. Etoricoxib (arcoxia) in rheumatology // Modern rheumatology. 2011. No. 2. URL: https://cyberleninka.ru/article/n/etorikoksib-arkoksia-v-revmatologii
  3. 2000-2022. REGISTER OF DRUGS OF RUSSIA® RLS ®
  4. Shostak N. A., Klimenko A. A. Non-steroidal anti-inflammatory drugs — modern aspects of their use. Clinician. 2013. No. 3-4. URL: https://cyberleninka.ru/article/n/nesteroidnye-protivovospalitelnye-preparaty-sovremennye-aspekty-ih-primeneniya
  5. Tatochenko VK Once again about antipyretics // VSP. 2007. No. 2. URL: https://cyberleninka.ru/article/n/eschyo-raz-o-zharoponizhayuschih-sredstvah

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