NSAIDs — What They Do, When to Use Them, and How to Stay Safe

NSAIDs (nonsteroidal anti-inflammatory drugs) are the go-to for headaches, muscle pain, arthritis flare-ups, and fever. They reduce pain and swelling fast, but they aren’t risk-free. Knowing which NSAID to pick, how much to take, and when to stop can save you from avoidable harm.

How NSAIDs work and common types

NSAIDs work by blocking enzymes called COX‑1 and COX‑2 that help make prostaglandins — chemicals that cause pain, fever, and inflammation. Common over-the-counter choices are ibuprofen (Advil, Motrin) and naproxen (Aleve). Aspirin is an older NSAID often used for heart protection in specific cases. Prescription NSAIDs include celecoxib (a COX‑2 selective drug), meloxicam, and diclofenac.

Typical OTC dosing: ibuprofen usually comes in 200 mg pills and people often take 200–400 mg every 4–6 hours as needed (follow the label and don’t exceed the max). Naproxen OTC tablets are usually 220 mg and taken every 8–12 hours. Always check the package or ask a pharmacist if you’re unsure.

Risks, interactions, and practical safety tips

Short-term NSAID use is fine for most adults, but problems rise with higher doses and long-term use. The main risks are stomach irritation, ulcers, and bleeding — especially if you take blood thinners, drink alcohol regularly, or are over 65. NSAIDs can also raise blood pressure, harm kidney function (worse if you’re dehydrated or on certain blood pressure meds), and increase heart risk, particularly with some prescription NSAIDs and long-term use.

Drug interactions to watch for: blood thinners (warfarin), many blood pressure medicines (ACE inhibitors, ARBs, diuretics), some antidepressants (SSRIs), and certain heart drugs. If you take any of these, check with your doctor before regular NSAID use.

Simple ways to reduce risk: take the lowest effective dose for the shortest time, swallow with food or milk to protect your stomach, avoid mixing multiple NSAID products, and don’t drink alcohol while using them. Avoid NSAIDs late in pregnancy — they can affect the baby’s heart circulation.

If you have ongoing pain, consider alternatives first: acetaminophen for pain without inflammation, topical NSAID gels for localized issues, or non‑drug options like physical therapy, heat/ice, and exercise. For chronic conditions, your doctor can suggest safer long‑term plans.

Watch for warning signs: black or bloody stools, severe stomach pain, chest pain, shortness of breath, sudden swelling, or reduced urine. If any of these occur, stop the NSAID and seek medical help right away.

Got questions about a specific NSAID or how it fits with your other meds? Ask your pharmacist or doctor — they can help pick the safest option for your situation.