MEDICINE_TXT/Chapter_02_NSAIDs.txt

CHAPTER 
2  
 
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) 
Dr. Nitin Nama 
 
 
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) constitute a widely used class of medications 
known for their ability to alleviate pain, reduce inflammation, and lower fever. Commonly available 
over-the-counter or through prescription, NSAIDs function by inhibiting enzymes involved in the 
production of prostaglandins, substances that play a key role in the inflammatory response. These 
drugs are frequently employed to manage conditions such as arthritis, muscle aches, and headaches. 
While NSAIDs provide effective relief for various ailments, it is essential to use them judiciously, 
considering potential side effects and individual health factors. Consulting with a healthcare 
professional ensures safe and appropriate use of NSAIDs for optimal therapeutic benefits. 
Over-the-Counter (OTC) NSAIDs, available without a prescription, mainly fall into the category of 
traditional NSAIDs. A simplified classification is given below: 
1. Non-Selective COX Inhibitors: 
● Ibuprofen: Widely used for pain relief and fever reduction. Brands include Advil and Motrin. 
(Explained in Analgesics Category) 
● Naproxen: Commonly used for various types of pain. Brands include Aleve. 
2. Acetylsalicylic Acid (Aspirin): 
● Though not exclusively OTC, aspirin is widely available without a prescription. It has analgesic, 
anti-inflammatory, and antipyretic properties. Brands include Bayer and Bufferin. 
It is crucial to follow recommended dosages and usage instructions when using OTC NSAIDs. 
Individuals with specific health conditions or those taking other medications should consult a 
healthcare professional before using these medications. 
Aspirin 
Aspirin, or acetylsalicylic acid, is a widely used analgesic and antipyretic with over a century of 
clinical history. However, caution is warranted, as high doses may cause liver injury, occasionally 
resulting in jaundice or dysfunction. Administered in lower doses to susceptible children with a febrile 
illness, it can contribute to Reye syndrome. As a non-steroidal anti-inflammatory agent, aspirin 
decreases prostaglandin synthesis, platelet aggregation, and inflammation, offering analgesic, 
antipyretic, and anticoagulant properties. 
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Chemical Information: 
● Chemical Name: 2-acetyloxybenzoic acid 
● Chemical Structure:  

[Chapter_02_NSAIDs_page2_img1.png]

 
Applications: 
• Used for angina (heart-related chest pain). 
• Employed in the treatment of heart attacks and strokes. 
Stability and Storage Conditions:Commonly stored at 40°C +/- 2 degrees and Relative Humidity 
(RH) of 75% +/- 5%. Long-term stability storage condition for the product is 25°C +/- 2 degrees and 
RH of 60% +/- 5%. 
Safe dose of Aspirin:The safe dose of aspirin for adults can vary based on individual health conditions 
and the reason for use.  

[Chapter_02_NSAIDs_page2_img2.png]

 
It is important to follow the guidance of a healthcare professional or the specific instructions provided 
on the medication packaging. However, for general reference: 
- Pain Relief and Fever:  
● Standard dose: 325 mg to 650 mg every 4-6 hours as needed. 
● Maximum dose: Up to 4,000 mg (4 grams) per day. 
Cardiovascular Protection:- For individuals using aspirin for cardiovascular protection (such as 
preventing heart attacks or strokes), the recommended dose is often lower and typically determined by 
a healthcare provider. 
It is crucial to adhere to the recommended dosage and not exceed the maximum daily limit without 
consulting a healthcare professional. Aspirin should be taken with food or a glass of milk to minimize 
the risk of gastrointestinal irritation. Additionally, individuals with specific health conditions or those 
taking other medications should consult their healthcare provider before using aspirin to ensure its 
safety and effectiveness for their situation. 
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Marketed Brands: 
• Ecosprin 
• Loprin 
• Delisprin 
• Aspeeday 
Naproxen 
Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), is widely utilized for its analgesic and 
anti-inflammatory properties. It functions by inhibiting the production of prostaglandins, substances in 
the body that contribute to pain and inflammation.  

[Chapter_02_NSAIDs_page3_img1.png]

 
Typically prescribed for conditions like arthritis, menstrual cramps, and various inflammatory 
conditions, naproxen provides relief by reducing pain, swelling, and stiffness. Available in different 
formulations. 
Chemical Name: (2S)-2-(6-methoxynaphthalen-2-yl)propanoic acid 
Chemical Structure:  

[Chapter_02_NSAIDs_page3_img2.png]

 
Uses: 
● Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) used primarily for relieving pain 
and reducing inflammation.  
● It is commonly prescribed for conditions such as arthritis, menstrual cramps, and inflammatory 
disorders. 
Stability and Storage Conditions: 
● Typically stored at room temperature, away from light and moisture. 
● Specific storage conditions may vary by formulation and manufacturer. 
Safe Dose for Adults: 
● The typical dose for pain relief ranges from 250 mg to 500 mg twice daily. 
● For chronic conditions like arthritis, the dosage may be higher, up to 1,500 mg per day. 
Marketed Brands: 
Naproxen is available under various brand names, including Aleve, Naprosyn, Anaprox. 
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FREQUENTLY ASKED QUESTIONS 
Question: What are NSAIDs? 
Answer: NSAIDs (nonsteroidal anti-inflammatory drugs) are a class of medications commonly used to 
relieve pain, reduce inflammation, and lower fever. 
Question: How do NSAIDs work? 
Answer: NSAIDs work by inhibiting the enzymes COX-1 and COX-2, which are involved in the 
production of prostaglandins, substances that promote inflammation, pain, and fever. 
Question: What conditions are NSAIDs commonly used to treat? 
Answer: NSAIDs are commonly used to treat conditions such as arthritis, menstrual cramps, 
headaches, muscle aches, dental pain, and minor injuries like sprains and strains. 
Question: What are some common examples of NSAIDs? 
Answer: Common examples of NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve), aspirin, 
diclofenac (Voltaren), and celecoxib (Celebrex). 
Question: What are some potential side effects of NSAIDs? 
Answer: Potential side effects of NSAIDs include stomach upset, heartburn, nausea, vomiting, 
diarrhea, gastrointestinal ulcers or bleeding, kidney damage, and increased risk of cardiovascular 
events like heart attack and stroke. 
Question: Can NSAIDs be taken with food? 
Answer: Yes, taking NSAIDs with food or milk can help reduce the risk of stomach upset and 
gastrointestinal side effects. 
Question: Are NSAIDs safe for everyone to take? 
Answer: While NSAIDs are generally safe for most people when used as directed, they may not be 
suitable for individuals with certain health conditions such as kidney disease, gastrointestinal ulcers, or 
a history of heart disease. It's important to consult with a healthcare professional before using NSAIDs, 
especially on a long-term basis or in high doses. 
Question: Can NSAIDs be used to treat COVID-19? 
Answer: While some initial studies suggested that NSAIDs might worsen outcomes in COVID-19 
patients, more recent evidence suggests that NSAIDs can be safely used to manage symptoms such as 
fever and body aches in individuals with COVID-19. However, it's essential to follow the advice of 
healthcare professionals and adhere to treatment guidelines. 
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