Introduction

Prescription NSAIDs (nonsteroidal anti-inflammatory drugs) can play an important role in the management of arthritis. Doctors may prescribe NSAIDs for patients who have both arthritis pain and inflammation. (For patients who have arthritis pain but not inflammation, doctors may prescribe other drugs, such as analgesics). NSAIDs are used to treat arthritis symptoms; they do not change the underlying condition of the disease.

Physicians can choose from more than a dozen prescription NSAID formulas based on a patient's needs. They are powerful drugs and can cause potential side effects. The most common side effects are nausea, headache, upset stomach, skin rash, and liver and kidney problems.

In some cases, prescription NSAIDs are stronger doses of drugs available over-the-counter. Other prescription NSAIDs have no over-the-counter version.

NSAIDs work by blocking chemical reactions in the body that contribute to pain and inflammation. But NSAIDs, in the process of blocking the inflammatory processes, also block beneficial chemical functions that protect the stomach lining and help to maintain kidney function. Thus, NSAIDs can lead to upset stomach, bleeding and peptic ulcers. Traditional prescription NSAIDs, generic and brand-name, include:

• diclofenac (the medicine in Voltaren®, Cataflam®).
• diflunisal (the medicine in Dolobid®).
• etodolac (the medicine in Lodine®).
• (the medicine in Ansaid®).
• ibuprofen (the medicine in Rufen®).
• indomethacin (the medicine in Indocin®).
• ketoprofen (the medicine in Orudis®).
• ketorolac (the medicine in Toradol®).
• meclofenamate (the medicine in Meclomen®).
• nabumetone (the medicine in Relafen®).
• naproxen (the medicine in Naprosyn® and Anaprox®).
• oxaprozin (the medicine in Daypro®).
• piroxicam (the medicine in Feldene®).
• salsalate (the medicine in Salflex® and Disalcid®).
• sulindac (the medicine in Clinoril®).
• tolmetin (the medicine in Tolectin®).

The goal is to provide the optimum relief at the lowest possible dosage and manage possible side effects. Unfortunately, some people have bad reactions to NSAIDs, as noted: stomach ulcers, internal bleeding, and other potentially serious reactions.

Only your doctor can determine the right medication for you. Many patients may not be candidates for NSAIDs. If you are allergic to aspirin or any type of NSAID, you may not be a candidate. Also, if you have heart problems, kidney problems, high blood pressure, or are pregnant you may also not be able to take NSAIDs.

Again, the possible side effects of NSAIDs can include constipation or diarrhea, dizziness, drowsiness, gas or heartburn, headache, nausea, vomiting, and insomnia. More serious side effects that you should report immediately to your doctor may include dark yellow or brown urine, decrease in the amount of urine passed, difficulty breathing, fast heartbeat, ringing in the ears, skin rash, redness, blistering, peeling or itching, swelling of eyelids, throat, lips or feet, unusual bleeding or bruising, and yellowing of eyes or skin.

Prescription NSAIDs are best taken with food or a glass of milk. Because ulcers or internal bleeding can occur without warning, regular checkups are important. If you consume more than three alcoholic drinks per day, talk with your doctor before using these products.

Prescription medications - like all medicines - should be taken with care. Give your doctor or pharmacist a complete list of all your other medications, including "over-the-counter" medications or herbal preparations. It is important for these people to have this information so that they can consider any potential drug interactions from medicines that you are taking.